Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study
Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study
复制标题
DOI：
10.1136/bmj.38933.585764.ae
复制
发表时间：
2006-09-16
影响因子：
--
通讯作者：
Lloyd, Andrew
中科院分区：
文献类型：
--
作者：
Hickie, Ian;Davenport, Trace;Lloyd, Andrew
目的探讨各种急性感染后长期患病的危险因素、症状类型和纵向病程。设计前瞻性队列研究，跟踪观察急性感染爱泼斯坦-巴尔病毒(腺热)、柯克斯巴尔病毒(Q热)或罗斯河病毒(流行性多发性关节炎)的患者。以澳大利亚乡村杜博镇周围为背景，半径200公里，居民10.44万人。研究对象253名患者，通过自我报告、结构化访谈和临床评估，每隔12个月定期进行一次自我报告、结构化访谈和临床评估，并在6个月后进行详细的医学、精神病学和实验室评估，以应用慢性疲劳综合征的诊断标准。记录发病前和并发疾病特征，以确定慢性疲劳综合征的危险因素。感染组之间自我报告的疾病表型比较。结果延长。在253名参与者中，29名(12%)在6个月时出现了以致残疲劳、肌肉骨骼疼痛、神经认知障碍和情绪障碍为特征的疾病，其中28名(11%)符合慢性疲劳综合征的诊断标准。这种感染后疲劳综合征的表型是刻板印象的，每次感染后的发病率相似。结论临床感染几种不同的病毒和非病毒微生物后，相当一部分患者会持续6个月或更长时间的感染后疲劳综合征。感染后疲劳综合征是研究慢性疲劳综合征的一种病理生理途径的有效疾病模型。
Objective To delineate the risk factors, symptom patterns, and longitudinal course of prolonged illnesses after a variety of acute infections.Design Prospective cohort stud), following patients from the time of acute infection with Epstein-Barr virus (glandular fever), Coxiella burnetti (Q fever), or Ross River virus (epidemic polyarthritis).Setting The region surrounding the township of Dubbo in rural Australia, encompassing a 200 km geographical radius and 104 400 residents.Participants 253 patients enrolled and followed at regular intervals over 12 months by self report, structured interview, and clinical assessment.Outcome measures Detailed medical, psychiatric, and laboratory evaluations at six months to apply diagnostic criteria for chronic fatigue syndrome. Premorbid and intercurrent illness characteristics recorded to define risk factors for chronic fatigue syndrome. Self reported illness phenotypes compared between infective groups.Results Prolonged. illness characterised by disabling fatigue, musculoskeletal pain, neurocognitive difficulties, and mood disturbance Was evident in 29 (12%) of 253 participants at six months, of whom 28 (11%) met die diagnostic criteria for chronic fatigue syndrome. This post-infective fatigue syndrome phenotype was stereotyped and occurred at a similar 1 incidence after each infection. The syndrome was predicted largely by the severity of the acute illness rather dian by demographic, psychological, or microbiological factors.Conclusions A relatively uniform post-infective fatigue syndrome persists in a significant minority of patients for six months or more after clinical infection With several different viral and non-viral micro-organisms. Post-infective fatigue syndrome is a valid illness model for investigating one pathophysiological pathway to chronic fatigue syndrome.