Bates D W, Buchwald D, Lee J, Kith P, Doolittle T, Rutherford C, Churchill W H, Schur P H, Wener M, Wybenga D
Department of Medicine, Brigham and Women's Hospital, Boston, Mass.
Arch Intern Med. 1995 Jan 9;155(1):97-103.
Results of readily available clinical laboratory tests in patients with chronic fatigue syndrome were compared with results in healthy control subjects.
Cases consisted of all 579 patients who met either the Centers for Disease Control and Prevention, Atlanta, Ga, British, or Australian case definition for chronic fatigue syndrome. They were from chronic fatigue clinics in Boston, Mass, and Seattle, Wash. Control subjects consisted of 147 blood donors who denied chronic fatigue. Outcome measures were the results of 18 clinical laboratory tests.
Age- and sex-adjusted odds ratios of abnormal results, comparing cases with control subjects, were as follows: circulating immune complexes, 26.5 (95% confidence interval [CI] 3.4-206), atypical lymphocytosis, 11.4 (95% CI, 1.4-94); elevated immunoglobulin G, 8.5 (95% CI, 2.0-37); elevated alkaline phosphatase, 4.2 (95% CI, 1.6-11); elevated total cholesterol, 2.1 (95% CI, 1.2-3.4); and elevated lactic dehydrogenase, 0.30 (95% CI, 0.16-0.56). Also, antinuclear antibodies were detected in 15% of cases vs 0% in the control subjects. The results of these tests were generally comparable for the cases from Seattle and Boston. Although these tests served to discriminate the population of patients from healthy control subjects, at the individual level they were not as useful.
Patients with chronic fatigue syndrome who were located in two geographically distant areas had abnormalities in the results of several readily available clinical laboratory tests compared with healthy control subjects. The immunologic abnormalities are in accord with a growing body of evidence suggesting chronic, low-level activation of the immune system in chronic fatigue syndrome. While each of these laboratory findings supports the diagnosis of chronic fatigue syndrome, each lacks sufficient sensitivity to be a diagnostic test. Furthermore, the specificity of these findings relative to other organic and psychiatric conditions that can produce fatigue remains to be established.
将慢性疲劳综合征患者易于获得的临床实验室检查结果与健康对照者的结果进行比较。
病例包括所有579例符合美国疾病控制与预防中心（位于佐治亚州亚特兰大）、英国或澳大利亚慢性疲劳综合征病例定义的患者。他们来自马萨诸塞州波士顿和华盛顿州西雅图的慢性疲劳诊所。对照者为147名否认有慢性疲劳的献血者。观察指标为18项临床实验室检查的结果。
将病例与对照者进行比较，经年龄和性别调整后的异常结果比值比如下：循环免疫复合物，26.5（95%置信区间[CI]3.4 - 206）；非典型淋巴细胞增多，11.4（95%CI，1.4 - 94）；免疫球蛋白G升高，8.5（95%CI，2.0 - 37）；碱性磷酸酶升高，4.2（95%CI，1.6 - 11）；总胆固醇升高，2.1（95%CI，1.2 - 3.4）；乳酸脱氢酶升高，0.30（95%CI，0.16 - 0.56）。此外，15%的病例检测到抗核抗体，而对照者中未检测到。西雅图和波士顿的病例的这些检查结果总体相当。虽然这些检查有助于区分患者群体与健康对照者，但在个体层面它们的作用不大。
与健康对照者相比，位于两个地理位置遥远地区的慢性疲劳综合征患者在几项易于获得的临床实验室检查结果中存在异常。免疫异常与越来越多的证据一致，这些证据表明慢性疲劳综合征中免疫系统存在慢性、低水平激活。虽然这些实验室检查结果中的每一项都支持慢性疲劳综合征的诊断，但每一项都缺乏足够的敏感性作为诊断试验。此外，这些发现相对于其他可导致疲劳的器质性和精神性疾病的特异性仍有待确定。
