Wolfe F, Anderson J, Harkness D, Bennett R M, Caro X J, Goldenberg D L, Russell I J, Yunus M B
Arthritis Research Center, and University of Kansas School of Medicine, Wichita 67214, USA.
Arthritis Rheum. 1997 Sep;40(9):1571-9. doi: 10.1002/art.1780400905.
To determine the intermediate and long-term outcomes of fibromyalgia in patients seen in rheumatology centers in which there is special interest in the syndrome.
We conducted a longitudinal outcome study by mailed comprehensive Health Assessment Questionnaire administered every 6 months to 538 patients, from 6 rheumatology centers, whose median duration of disease at first assessment was 7.8 years. The final assessment took place after 7 years. In addition, there was study followup on 85 patients who had attended the Wichita center for > 10 years.
Although functional disability worsened slightly and health satisfaction improved slightly, measures of pain, global severity, fatigue, sleep disturbance, anxiety, depression, and health status were markedly abnormal at study initiation and were essentially unchanged over the study period. Correlations between first and last assessment values were as high as r = 0.82. For some variables, abnormalities were 3 times greater at one center compared with another.
Patients with established fibromyalgia, seen in rheumatology centers in which there a special interest in the disease and followed up for as long as 7 years, have markedly abnormal scores for pain, functional disability, fatigue, sleep disturbance, and psychological status, and these values do not change substantially over time. Half the patients are dissatisfied with their health, and 59% rate their health as fair or poor. There are marked differences in disease severity among the various centers, but < 14% of the variance in outcomes can be explained by demographic or center factors. Values at the first assessment are predictive of final values.
确定在对该综合征有特别关注的风湿病中心就诊的纤维肌痛患者的中长期预后。
我们进行了一项纵向预后研究，通过每6个月邮寄一次综合健康评估问卷，对来自6个风湿病中心的538名患者进行调查，这些患者在首次评估时疾病的中位病程为7.8年。最终评估在7年后进行。此外，对85名在威奇托中心就诊超过10年的患者进行了研究随访。
尽管功能残疾略有恶化，健康满意度略有提高，但疼痛、总体严重程度、疲劳、睡眠障碍、焦虑、抑郁和健康状况等指标在研究开始时明显异常，并且在研究期间基本没有变化。首次和末次评估值之间的相关性高达r = 0.82。对于某些变量，一个中心的异常情况比另一个中心大三倍。
在对该疾病有特别关注且随访长达7年的风湿病中心就诊的确诊纤维肌痛患者，在疼痛、功能残疾、疲劳、睡眠障碍和心理状态方面的评分明显异常，并且这些值不会随时间发生实质性变化。一半的患者对自己的健康状况不满意，59%的患者将自己的健康状况评为一般或较差。各个中心之间疾病严重程度存在显著差异，但结局差异中<14%可由人口统计学或中心因素解释。首次评估时的值可预测最终值。
