Fibromiyalji Tanısı İçin Eski ve Yeni Kriterler: Değerlendirme ve Karşılaştırma

Öz

Amaç: Eski ve yeni Fibromiyalji Sendromu (FMS) tanı kriterleri arasındaki farklılıkları değerlendirmek ve tanı kriterleri ile Fibromiyalji Etki Anketi (FEA) arasındaki ilişkiyi saptamaktır.
Materyal ve Metot: Yaygın ağrı şikayeti olan 132 kadın hasta çalışmaya dahil edildi. Hastalara ACR 1990; hassas nokta sayısı, ACR 2010; yaygın ağrı indeksi (YAİ)-semptom şiddet skalası (SSS), ACR 2010 modifiye kriterler; (YAİ-modifiye skor) ve 2013 ACR alternatif tanı kriterleri; ağrı yerleşim skoru (AYS)-semptom etki skoru (SES) ile uygulandı. Fonksiyonel durum değerlendirilmesi Fibromiyalji Etki Anketi (FEA) ile yapıldı. 

Bulgular: Hastaların ortalama yaşı 47,68±8,31 yıl idi. Ortalama BMI 29,34±4,92 idi. ACR 1990 kriterlere göre hastaların %34,80’i FMS tanısı alırken, ACR 2010 kriterlerine göre %37,90 hasta, ACR 2010-mod kriterlerine göre %42,40 hasta, 2013 ACR alternatif kriterlerine göre %18,20 hasta FMS tanısı almıştı. ACR 1990, ACR 2010 ve ACR 2010-mod kriterleri arasında farklılık gözlenmezken, ACR 2013 alternatif kriterleri AYS ve SES skoru ile diğerlerinden anlamlı olarak farklıydı (p<0,05). Hassas nokta sayısı ile FEA total skor arasında anlamlı korelasyon vardı (r: 0.511 p<0,001). SSS ile FEA total skor (r: 0.643 p<0,001), modifiye skor ile FEA total skor ilişkiliydi (r: 0,417 p<0.05). Hassas nokta sayısı, YAİ (r=0,363 p<0,05) ve SSS (r=0,290 p<0,05) ile pozitif yönde anlamlı; modifiye skor ile pozitif yönde anlamlı (r= 0,342 p<0,05) korelasyon saptandı. Hassas nokta sayısı ile AYS ve SES skoru arasında korelasyon saptanmadı (p>0,05).

Sonuç: ACR 1990, ACR 2010 ve modifiye 2010 ACR kriterleri arasında tanı koyma sıklığı açısından anlamlı bir fark saptanmamıştır. ACR 2013 alternatif kriterleri ise tanı koyma oranını anlamlı derecede azaltmıştır. FMS’nin neden olduğu yaşam kalitesi ve fonksiyonel durum değişikliklerinin SŞS ile ilişkilidir. 

Anahtar Kelimeler

• Fibromiyalji,tanı kriterleri,Fibromiyalji etki anketi

Old and New Criteria for the Diagnosis of Fibromyalgia: Comparison and Evaluation

Abstract

Objectives: To evaluate the differences between the diagnostic criteria of old and new Fibromyalgia Syndrome (FMS) and to determine the relationship between the diagnostic criteria and the Fibromyalgia Impact Questionnaire (FIQ).

Materials and Methods: A total of 132 women with generalized pain were included in the study. ACR 1990 to the patients, the number of tender points, ACR 2010; widespread pain index (WPI) - symptom severity scale (SSS), ACR 2010 modified criteria; (WPI-modified score) and alternative diagnostic criteria for 2013 ACR; pain location score (PLS) was applied with Symptom Impact Questionnaire (SIQR). Functional status evaluation was performed with FIQ.

Results: The mean age of the patients was 47.68 ± 8.31 years. The mean BMI was 29.34 ± 4.92. While 34.8% of the patients were diagnosed as FMS according to ACR 1990 criteria, 37.9% according to ACR 2010 criteria, 42.4% according to ACR 2010-mode criteria and 18.2% according to ACR alternative criteria were diagnosed as FMS. While ACR 1990, ACR 2010 and ACR 2010-mode criteria did not differ, the ACR 2013 alternative criteria were significantly different from those of the others by WPI and SES score (p <0.05). FIQ total score was correlated with SSS (r: 0.643 p <0.001) and modified score (r: 0.417 p <0.05). The number of tender points was positively significant with WPI (r = 0.363 p <0.05) and SSS (r = 0.290 p <0.05); There was a significant positive correlation (r = 0.342 p <0.05) with the modified score. There was no correlation between the number of tender points and the score of PLS and SIQR (p> 0.05).

Conclusion: There was no significant difference between the ACR 1990, ACR 2010 and modified 2010 ACR criteria in terms of diagnosis frequency. The ACR2013 alternative criteria significantly reduced the rate of diagnosis. Quality of life and functional state changes caused by FMS are associated with SSS.

Keywords

• Fibromyalgia,diagnostic criteria,Fibromyalgia Impact Questionnaire

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