Fibromiyalji Tanısı İçin Eski ve Yeni Kriterler: Değerlendirme ve Karşılaştırma

Year 2019, Volume: 19 Issue: 1, 83 - 95, 22.03.2019

Ayla Çağlıyan Türk

https://doi.org/10.17098/amj.542154

Abstract

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. 

Keywords

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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