Buskila D, Shnaider A, Neumann L, Zilberman D, Hilzenrat N, Sikuler E
Department of Medicine B, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Arch Intern Med. 1997 Nov 24;157(21):2497-500.
Fibromyalgia syndrome (FS) is a common disorder of diffuse pain in the muscles or joints accompanied by tenderness at specific tender points and a constellation of related symptoms. The potential role of infections in the pathogenesis of FS has only recently been investigated.
To evaluate the prevalence of FS and to assess tenderness thresholds in patients infected with hepatitis C virus (HCV).
The study included 90 patients with HCV, 128 healthy, anti-HCV-negative controls, and 32 patients with non-HCV-related cirrhosis. Tenderness was measured by manual palpation (18 tender points) and with a dolorimeter. Fibromyalgia syndrome was diagnosed according to the 1990 American College of Rheumatology criteria.
The diagnosis of FS was established in 14 patients (16%) with HCV, in 1 patient (3%) with non-HCV-related cirrhosis, and in none of the healthy controls (P < .001). Thirteen of the HCV-positive patients with FS were women. The patients with HCV had significantly (P < .01) more tender points (mean [+/- SD] 3.6 +/- 5.3) than the healthy controls (0.1 +/- 0.5) and the patients with non-HCV-related cirrhosis (1.2 +/- 2.7). Specifically, the patients with cirrhosis were most tender on both tenderness measures owing to the high proportion of women in this group. Patients with FS were significantly more tender than those without FS: their dolorimetry thresholds were 2.9 kg vs 6.0 kg (P < .001).
A high prevalence of FS was observed in patients infected with HCV, especially women. Recognizing FS in patients with HCV will prevent misinterpretation of FS symptoms as part of the liver disease and will enable the physician to reassure the patient about these symptoms and to alleviate them.
纤维肌痛综合征（FS）是一种常见的弥漫性肌肉或关节疼痛疾病，伴有特定压痛点压痛及一系列相关症状。感染在FS发病机制中的潜在作用直到最近才被研究。
评估丙型肝炎病毒（HCV）感染患者中FS的患病率，并评估其压痛阈值。
该研究纳入了90例HCV患者、128例健康的抗HCV阴性对照者以及32例非HCV相关肝硬化患者。通过手动触诊（18个压痛点）和痛觉计测量压痛。根据1990年美国风湿病学会标准诊断纤维肌痛综合征。
14例（16%）HCV患者、1例（3%）非HCV相关肝硬化患者被诊断为FS，健康对照者中无人被诊断为FS（P <.001）。13例HCV阳性且患有FS的患者为女性。HCV患者的压痛点明显多于健康对照者（P <.01）（平均[±标准差]3.6 ± 5.3个）和非HCV相关肝硬化患者（1.2 ± 2.7个）。具体而言，由于该组女性比例高，肝硬化患者在两种压痛测量方法下的压痛最为明显。患有FS的患者比未患FS的患者压痛明显更甚：他们的痛觉计阈值分别为2.9千克和6.0千克（P <.001）。
在HCV感染患者中观察到FS的高患病率，尤其是女性。认识到HCV患者中的FS将避免将FS症状误解为肝病的一部分，并使医生能够就这些症状安抚患者并减轻症状。
