验证改良后的 2010 年美国风湿病学会纤维肌痛诊断标准在西班牙人群中的适用性。

Validation of the modified 2010 American College of Rheumatology diagnostic criteria for fibromyalgia in a Spanish population.

机构信息

Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain. Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain.

出版信息

Rheumatology (Oxford). 2014 Oct;53(10):1803-11. doi: 10.1093/rheumatology/keu169. Epub 2014 May 14.

DOI:10.1093/rheumatology/keu169

PMID:24829222

Abstract

OBJECTIVE

The aim of this study was to validate the modified 2010 ACR preliminary criteria for FM in a Spanish population.

METHODS

Five hundred and seventy-nine (550 women) FM and 294 (240 women) control participants were enrolled in the study. FM patients were previously diagnosed by a rheumatologist. All participants underwent both the 1990 ACR criteria (1990c) and the modified 2010 ACR criteria (m-2010c).

RESULTS

The tender points count showed correlations of 0.69, 0.65 and 0.71 with the widespread pain index (WPI), symptoms severity (SS) and polysymptomatic distress (PSD) scales, respectively (all P < 0.001). The WPI, SS and PSD showed greater correlations with impact of FM health-related quality of life, general fatigue and depression than the tender points count. The 1990c showed sensitivity and specificity values of 84.1 and 97.6, respectively, whereas the m-2010c showed values of 88.3 and 91.8, respectively. Both criteria showed the same overall accuracy, with a value of 0.89. When the 1990c and m-2010c were combined and patients had to satisfy one of two criteria to be diagnosed with FM, the sensitivity, specificity and accuracy of questionnaires were 96.7, 89.8 and 0.94, respectively. The original cut-off points (WPI ≥ 7, SS ≥ 5 and PSD ≥ 12) showed the best test characteristics in the present study.

CONCLUSION

The m-2010c, with the same cut-off points as the original version, are a valid tool for the diagnosis of FM in our population. Whenever possible, the combination of the 1990c and m-2010c is recommended (patients have to meet one of the two criteria to be diagnosed), since this approach showed the best diagnostic characteristics.

摘要

目的

本研究旨在验证改良的 2010 年 ACR 初步标准在西班牙人群中对纤维肌痛（FM）的适用性。

方法

本研究共纳入 579 名（550 名女性）FM 患者和 294 名（240 名女性）对照组参与者。FM 患者由风湿病学家预先诊断。所有参与者均接受了 1990 年 ACR 标准（1990c）和改良的 2010 年 ACR 标准（m-2010c）的评估。

结果

压痛点数与广泛疼痛指数（WPI）、症状严重程度（SS）和多症状困扰（PSD）评分分别相关，相关系数分别为 0.69、0.65 和 0.71（均 P < 0.001）。WPI、SS 和 PSD 与 FM 健康相关生活质量、一般疲劳和抑郁的影响相关性更高，而非压痛点数。1990c 的敏感性和特异性值分别为 84.1%和 97.6%，而 m-2010c 的敏感性和特异性值分别为 88.3%和 91.8%。两种标准的整体准确性相同，为 0.89。当将 1990c 和 m-2010c 结合使用且患者必须满足两种标准之一才能被诊断为 FM 时，问卷的敏感性、特异性和准确性分别为 96.7%、89.8%和 0.94。本研究中，原始截断值（WPI≥7、SS≥5 和 PSD≥12）表现出最佳的测试特征。