Mukerji B, Mukerji V, Alpert M A, Selukar R
University of South Alabama, Mobile, USA.
Angiology. 1995 May;46(5):425-30. doi: 10.1177/000331979504600510.
The purpose of this study was to determine the prevalence of musculoskeletal disorders in patients with chest pain and angiographically normal coronary arteries. The authors studied 40 consecutive patients with chest pain presenting at an Internal Medicine Clinic who had undergone coronary angiography and were found to have < 30% stenosis of all major coronary arteries. Patients with any known noncardiac cause of chest pain were excluded from the study. Each patient underwent a complete rheumatologic examination with x-rays and blood tests when indicated. The diagnosis of fibromyalgia was based on the presence of at least eight paired tender points. The diagnosis of costochondritis was made when palpation of the costal cartilages elicited tenderness. In the normal coronary artery group, 30% of the patients had fibromyalgia and 10% had costochondritis. In the control group of 40 patients with coronary artery disease, only 1 patient had fibromyalgia and none had costochondritis (P < 0.04). Other rheumatologic disorders were uncommon, with no statistical difference between the two groups. The authors conclude that many patients with chest pain and angiographically normal coronary arteries suffer from rheumatologic disorders with fibromyalgia being the most common.
本研究的目的是确定胸痛且冠状动脉造影正常的患者中肌肉骨骼疾病的患病率。作者研究了40例连续就诊于内科门诊且接受过冠状动脉造影检查、发现所有主要冠状动脉狭窄<30%的胸痛患者。有任何已知非心脏原因导致胸痛的患者被排除在研究之外。每位患者在必要时均接受了包括X线和血液检查在内的全面风湿病学检查。纤维肌痛的诊断基于至少8对压痛点的存在。肋软骨炎的诊断依据是触诊肋软骨时引起压痛。在冠状动脉正常组中，30%的患者患有纤维肌痛，10%的患者患有肋软骨炎。在40例冠心病对照组中，只有1例患者患有纤维肌痛，无人患有肋软骨炎（P<0.04）。其他风湿病并不常见，两组之间无统计学差异。作者得出结论，许多胸痛且冠状动脉造影正常的患者患有肌肉骨骼疾病，其中纤维肌痛最为常见。
