伴有病原体感染的慢性疲劳综合征病例临床特征的系统评价

Clinical Features of Chronic Fatigue Syndrome Cases with Pathogens Infection:A Systematic Review

目的系统分析慢性疲劳综合征(CFS)合并病原体感染病例的临床特征。方法计算机检索VIP、WanFang Data、CNKI、CBM、PubMed、MEDLINE、EMbase、The Cochrane Library、Web of Science和Elesiver数据库以及Google Scholar,搜集CFS与病原体感染相关的文献,检索时限均从1994年至2014年。由2位评价员独立筛选文献、提取资料,并按病例人口学特征信息、临床表现、病原体感染类型及实验室检查指标等信息进行整理分析。结果共纳入84篇文献,2 656例病例,这些病例来自18个国家。感染的病原体类型主要有支原体、EB病毒、肠道病毒、伯纳特氏立克次体、人类疱疹病毒和肠道革兰阴性杆菌等。57篇文献提示病原体感染与CFS发病之间可能存在关联,虽感染病原体类型不同,但均推论感染可能导致机体免疫功能失调,引起机体出现CFS的相关症状。结论病原体感染可能与CFS的发病相关,但受纳入研究设计所限,两者相关性仍需进一步研究确认。

Objective To systematically review the clinical features of chronic fatigue syndrome（CFS） cases with pathogens infection. Methods We electronically searched databases including VIP, WanFang Data, CNKI, CBM,PubMed, MEDLINE, EMbase, The Cochrane Library, Web of Science, Elsevier and Google Scholar from 1994 to 2014 for CFS-related studies. Two reviewers independently screened literature and extracted data. Then we systematically reviewed and analyzed the information on demographic characteristics, clinical manifestations, types of infected pathogens, and results of some biochemical examinations. Results A total of 84 studies（case reports and case series） involving 2 565 CFS cases from 18 countries were included. The major infected pathogens of included CFS cases were mycoplasma, EB virus, intestinal virus, Bernat rickettsia, human-herpes virus, and Gram-negative intestinal bacteria. Fifty-seven studies reported that there might be associations between the pathogenic infection and CFS pathogenesis. Although there were different types of CFS-related pathogens, almost all the studies inferred that pathogens infection linked with immune dysfunction, which might cause CFS symptoms. Conclusion There may be associations between the pathogenic infection and CFS pathogenesis.