Onset Patterns and Course of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Onset Patterns and Course of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
复制标题
DOI：
10.3389/fped.2019.00012
复制
发表时间：
2019-02-05
影响因子：
2.6
通讯作者：
Montoya, Jose G.
中科院分区：
文献类型：
--
作者：
Chu, Lily;Valencia, Ian J.;Montoya, Jose G.
背景资料：肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）的流行病学研究已经分别研究了这种疾病的不同方面，但很少有探讨themtogether.Objective：描述ME/CFS发病和过程中的一个美国为基础的coherent.Methods：一百五十个主题拟合福田1994年CFS标准完成了详细的调查，关于他们的疾病的初始阶段和后续阶段。描述性统计，图形和表格被用来说明患病率和模式的characteristic.Results：最常见的围发病期事件报告的主题是感染相关的事件（64%），压力事件（39%），暴露于环境毒素（20%）。对于38%的受试者，从经历任何初始症状到出现包括ME/CFS的一系列症状超过6个月。随着时间的推移，12种最常见的症状持续存在，但患病率下降，其中疲劳，睡眠不足，与运动有关的疾病和流感样症状下降最多（20-25%）。相反，认知症状的患病率变化最小，症状排名上升。怀孕、更年期和月经周期加剧了许多女性的症状。糖尿病相关功能与疾病持续时间或年龄无关;在疾病最严重的时期，48%的受试者不能从事任何生产活动。在调查时，47%的人无法工作，只有4%的人认为他们的状况正在稳步改善，大多数人（59%）描述了一个波动的过程。97%的人患有至少一种其他疾病：焦虑（48%），抑郁（43%），纤维肌痛（39%），肠易激综合征（38%）和偏头痛（37%）是最常见的诊断条件。13%的人来自至少有一名其他一级亲属也患有这种疾病的家庭，当纳入病因不明的慢性疲劳时，这一比例上升至27%。结论：本文提供了美国ME/CFS队列的广泛流行病学概述。虽然我们的大部分发现与先前的研究一致，但我们强调了这种疾病的未充分研究的方面（例如，症状的演变），并对发现提出新的解释。研究这些方面可以提供洞察力和解决方案的诊断，病因学，病理生理学和治疗这种情况。
Background: Epidemiologic studies of myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) have examined different aspects of this disease separately but few have explored them together.Objective: Describe ME/CFS onset and course in one United States-based cohort.Methods: One hundred and fifty subjects fitting Fukuda 1994 CFS criteria completed a detailed survey concerning the initial and subsequent stages of their illness. Descriptive statistics, graphs, and tables were used to illustrate prevalence and patterns of characteristics.Results: The most common peri-onset events reported by subjects were infection-related episodes (64%), stressful incidents (39%), and exposure to environmental toxins (20%). For 38% of subjects, more than 6 months elapsed from experiencing any initial symptom to developing the set of symptoms comprising their ME/CFS. Over time, the 12 most common symptoms persisted but declined in prevalence, with fatigue, unrefreshing sleep, exertion-related sickness, and flu-like symptoms declining the most (by 20-25%). Conversely, cognitive symptoms changed the least in prevalence, rising in symptom ranking. Pregnancy, menopause, and menstrual cycles exacerbated many women's symptoms. Fatigue-related function was not associated with duration of illness or age; during the worst periods of their illness, 48% of subjects could not engage in any productive activity. At the time of survey, 47% were unable to work and only 4% felt their condition was improving steadily with the majority (59%) describing a fluctuating course. Ninety-seven percent suffered from at least one other illness: anxiety (48%), depression (43%), fibromyalgia (39%), irritable bowel syndrome (38%), and migraine headaches (37%) were the most diagnosed conditions. Thirteen percent came from families where at least one other first-degree relative was also afflicted, rising to 27% when chronic fatigue of unclear etiology was included.Conclusions: This paper offers a broad epidemiologic overview of one ME/CFS cohort in the United States. While most of our findings are consistent with prior studies, we highlight underexamined aspects of this condition (e.g., the evolution of symptoms) and propose new interpretations of findings. Studying these aspects can offer insight and solutions to the diagnosis, etiology, pathophysiology, and treatment of this condition.