Dohrenbusch R, Grüterich M, Genth E
Rheumaklinik und Rheumaforschungs-institut Aachen.
Z Rheumatol. 1996 Jan-Feb;55(1):19-27.
The prevalence of fibromyalgia in primary (n = 18) or secondary (n = 20) Sjögren's syndrome was examined. In all patients with Sjögren's syndrome as well as in 31 fibromyalgia patients and 20 healthy individuals measurements of pressure pain threshold were done by palpation and dolorimetry. Widespread pain, functional complaints, as well as depression were determined by a questionnaire. The results show a high frequency of fibromyalgia in the group of patients with pSS (44%), 72% of pSS patients reported widespread pain. Only 5% of the sSS patients fulfilled the ACR criteria for fibromyalgia and 40% of this group reported on widespread pain. Dolorimetry measures at tender or control points revealed that the pressure pain threshold was significantly reduced in all patient groups with healthy controls. There were only small differences between the clinical groups. Within the different groups examined there was a close correlation between dolorimetric threshold at tender and control points. In contrast to self-estimated widespread pain the pressure pain threshold was not closely related to functional complaints in the patient groups. The prevalence of depression was increased in both pSS and FM patients, in contrast to the other groups. The results suggest to include Sjögren's syndrome into the differential diagnosis of FM. The dolorimetric results were interpreted as an argument against the actual tenderpoint concept. They support the view that patients with FM rather represent an arbitrary coincidence of widespread pain and elevated tenderness on pressure.
研究了原发性（n = 18）或继发性（n = 20）干燥综合征中纤维肌痛的患病率。对所有干燥综合征患者以及31名纤维肌痛患者和20名健康个体，通过触诊和痛觉测量法测量压痛阈值。通过问卷调查确定广泛性疼痛、功能障碍以及抑郁情况。结果显示，原发性干燥综合征患者组中纤维肌痛的发生率较高（44%），72%的原发性干燥综合征患者报告有广泛性疼痛。只有5%的继发性干燥综合征患者符合美国风湿病学会（ACR）纤维肌痛标准，该组中有40%的患者报告有广泛性疼痛。在压痛点或对照点进行的痛觉测量显示，与健康对照组相比，所有患者组的压痛阈值均显著降低。各临床组之间只有微小差异。在所检查的不同组中，压痛点和对照点的痛觉测量阈值之间存在密切相关性。与自我评估的广泛性疼痛不同，患者组的压痛阈值与功能障碍并无密切关联。与其他组相比，原发性干燥综合征和纤维肌痛患者组的抑郁患病率均有所增加。结果提示应将干燥综合征纳入纤维肌痛的鉴别诊断。痛觉测量结果被解释为反对当前压痛点概念的一个论据。这些结果支持了这样一种观点，即纤维肌痛患者更像是广泛性疼痛和压痛敏感性增加的一种任意组合。
