Buskila D, Fefer P, Harman-Boehm I, Press J, Neumann L, Lunenfeld E, Gedalia A, Potashnik G, Sukenik S
Rheumatic Disease Unit, Ben-Gurion University, Beer Sheva, Israel.
J Rheumatol. 1993 Dec;20(12):2112-5.
To assess nonarticular tenderness and prevalence of fibromyalgia syndrome (FMS) in hyperprolactinemic subjects.
Twenty-one consecutive women with hyperprolactinemia (HPRL) and 44 consecutive women with normal prolactin levels (PRL) were examined in the fertility unit by one observer during a 24-month period. Mean age was 31 years, range 22-46 years. Hyperprolactinemia was defined as PRL levels > 24.5 ng/ml (immunoradiometric assay). In all women, a count of 18 tender points (TP) was conducted by thumb palpation. Tenderness of some of the TP sites (9 points) as well as control point sites (4 points) was further assessed using a Chatillon dolorimeter. All women were questioned about the presence of widespread pain or aching. Women were considered to have FMS if they met the American College of Rheumatology (ACR) criteria for diagnosis.
Of the 21 women with HPRL, 15 (71%) had FMS vs only 2 of 44 (4.5%) normoprolactinemic women (p < 0.0001). Thresholds of tenderness of 9 fibrositic points were 2.7 (1.5) kg [mean (standard deviation)] for HPRL women vs 5.0 (1.4) (kg) for women with normal PRL (p < 0.0001). Thresholds of tenderness of 4 control points were 5.2 (1.5) (kg) for women with HPRL vs 6.8 (1.1) (kg) for normoprolactinemic women (p < 0.0001). The frequency of FMS was directly associated with the level of PRL.
We suggest that FMS is very common in a subset of women with HPRL and that its frequency is directly associated with the degree of hyperprolactinemia. Women with HPRL have lower thresholds of tenderness than women with normal PRL. More studies are needed to clarify the relationships between PRL, FMS and tenderness.
评估高泌乳素血症患者的非关节压痛及纤维肌痛综合征（FMS）的患病率。
在24个月期间，由一名观察者在生育科对21例连续的高泌乳素血症（HPRL）女性和44例连续的泌乳素水平正常（PRL）的女性进行检查。平均年龄为31岁，范围为22 - 46岁。高泌乳素血症定义为PRL水平>24.5 ng/ml（免疫放射分析）。对所有女性通过拇指触诊计数18个压痛点（TP）。使用Chatillon压痛计进一步评估部分TP部位（9个点）以及对照点部位（4个点）的压痛情况。询问所有女性是否存在广泛疼痛或酸痛。如果女性符合美国风湿病学会（ACR）诊断标准，则被认为患有FMS。
21例HPRL女性中，15例（71%）患有FMS，而44例泌乳素水平正常的女性中只有2例（4.5%）患有FMS（p < 0.0001）。9个纤维肌痛点的压痛阈值，HPRL女性为2.7（1.5）kg[平均值（标准差）]，PRL正常的女性为5.0（1.4）kg（p < 0.0001）。4个对照点的压痛阈值，HPRL女性为5.2（1.5）kg，泌乳素水平正常的女性为6.8（1.1）kg（p < 0.0001）。FMS的发生率与PRL水平直接相关。
我们认为FMS在一部分HPRL女性中非常常见，其发生率与高泌乳素血症的程度直接相关。HPRL女性的压痛阈值低于PRL正常的女性。需要更多研究来阐明PRL、FMS和压痛之间的关系。
