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结构化症状评估以识别纤维纤维或自主神经病变的患者

Charlotte N Bay-Smidt¹, Karin D Bruun², Laura M Gaist^1,3

¹Department of Neurology, Odense University Hospital, Odense, Denmark.

European journal of neurology

|September 6, 2025

概括

纤维肌痛患者很少有小纤维神经病变或自主神经病变. 症状得分表明这些情况很常见,但与本研究中的实际诊断无关.

科学领域:

神经学
治疗疼痛的方法
自主神经科学

背景情况:

纤维肌痛是一种慢性疼痛疾病,经常伴有自主功能障碍的症状.
一部分 FM 患者表现出小纤维神经病变 (SFN).
症状评估在识别FN或自主神经病变时的有用性需要进一步研究.

研究的目的:

评估结构化症状评估在识别有SFN或自主神经病变的纤维肌痛患者中的有效性.
将 FM 患者的症状评分与对照组和已确定的神经病变患者的症状评分进行比较.

主要方法:

一项对46名女性 FM 患者进行的横截面研究.
使用了临床检查,验证了问卷 (m-NPSI,PainDETECT,COMPASS 31) 和诊断测试 (IENFD,QST,QSART).
根据已确定的标准定义了SFN和心血管自主神经病变 (CAN).

主要成果:

在一个FM患者中发现了SFN,在两个患者中发现了确定的CAN.
经常出现高症状得分,暗示神经病变/ 自动障碍 (NPSI: 32/46, 疼痛检测: 20/46, COMPASS 31: 43/46).
尽管SFN/ CAN诊断不频繁,但 FM患者的症状得分高于已确诊的神经病症患者.

结论:

在纤维肌痛患者中,SFN和自主神经病变不常见.
症状评估得分暗示神经病变/ 脱机症在 FM 中升高,但不能可靠地表明 SFN 或自主神经病变.
需要进一步研究以了解纤维肌痛的主观症状与客观发现之间的关系.

关键词:

自主神经病变纤维肌痛小纤维神经病变

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