小结
定义
病史和体格检查
关键诊断因素
- 慢性疼痛
- 体格检查提示广泛的压痛
其他诊断因素
- 休息后仍不能缓解的疲劳感
- 睡眠障碍
- 情绪障碍
- 认知功能障碍
- 头痛
- 麻木/刺痛的感觉
- 僵硬
- 对感官刺激过敏,包括明亮的光线、气味和噪音。
危险因素
- 纤维肌痛家族史
- 风湿性疾病
- 年龄在20到60岁之间
- 女性
- 存在相关疾病
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 红细胞沉降率/CRP
- 甲状腺功能检测
- 全血细胞计数(FBC)
- 类风湿因子
- 抗环胍氨酸(CCP)抗体
- 抗核抗体
- 维生素 D 水平
治疗流程
所有患者
撰稿人
作者
Daniel J. Clauw, MD
Professor of Anesthesiology, Medicine, and Psychiatry
University of Michigan Health System
Ann Arbor
MI
利益声明
DJC has received consulting fees from Pfizer, Eli Lilly, Nuvo, Cerephex, Tonix, Abbott, Forest Laboratories, Johnson & Johnson, Merck, Purdue Pharma, Zynerba, Astellas Pharmaceuticals, Williams & Connolly LLP, and Aptinyx; he has received research grant support from Pfizer, Cypress Biosciences, Forest Laboratories, Merck, Novo, Cerephex, and Aptinyx. DJC is an author of a number of references cited in this topic.
鸣谢
Dr Daniel J. Clauw would like to gratefully acknowledge Dr Lisa Ware Corbin, a previous contributor to this topic.
利益声明
LWC declares that she has no competing interests.
同行评议者
Don Goldenberg, MD
Emeritus Professor of Medicine
Tufts University School of Medicine
Boston
MA
利益声明
DG declares that he has no competing interests.
Robert Bennett, MD
Professor of Medicine and Nursing Research
Oregon Health & Science University
Portland
OR
利益声明
RB declares that he has no competing interests.
鉴别诊断
- 肌筋膜痛综合征
- 维生素 D 缺乏症
- 慢性疲劳综合征
更多 鉴别诊断指南
- 纤维肌痛的 ACTTION-APS 疼痛分类法(AAPT)诊断标准
- EULAR 修订了纤维肌痛综合征的管理建议
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