【摘要】：從2009年6月開始,國家衛(wèi)生部門連續(xù)接到了很多“患者”的反映,他們認為自己已經(jīng)感染了HIV,并在不安全性行為后出現(xiàn)很多類似艾滋病的相關(guān)癥狀。衛(wèi)生部對“患者”的訴求高度重視,并組織相關(guān)的部門對他們展開咨詢和調(diào)查。近年來一些研究機構(gòu)和團隊也積極參與研究。但是,該群體的主訴癥狀與常規(guī)臨床檢測結(jié)果有明顯背離的傾向使這一問題復(fù)雜化。心理學(xué)說與病原體感染學(xué)說成為相關(guān)研究者爭論的焦點。我們在前期的觀察顯示,該人群顯示出的群體化特征包括:嚴重疲勞,全身/局部肌肉關(guān)節(jié)疼痛、低熱盜汗、淋巴節(jié)腫大、咽喉炎、牙齦萎縮、舌苔白膩、皮疹等。結(jié)合系統(tǒng)分析的結(jié)果,其癥狀特點與病原體感染引發(fā)的CFS相似。因此在本課題中我們擬采用流行病學(xué)調(diào)查方法進一步觀察、描述這一“疾病”特點,為深入驗證這一假設(shè)提供依據(jù)。研究結(jié)果如下:1.以2000至2014年間發(fā)表于Web of Science數(shù)據(jù)庫的CFS相關(guān)文獻為研究對象,利用可視化軟件CiteSpaceⅢ,繪制與CFS相關(guān)的科學(xué)知識圖譜。分析發(fā)現(xiàn)國際上圍繞CFS領(lǐng)域的研究和探索已經(jīng)取得重要進展。其中美、英等發(fā)達國家的科學(xué)團隊貢獻最多�，F(xiàn)況研究、CFS癥狀與機體神經(jīng)系統(tǒng)功能的關(guān)聯(lián)、心理干預(yù)、病因探索、認知治療對CFS的療效研究等,成為了CFS領(lǐng)域的主要研究方向。2.CFS領(lǐng)域近些年的研究前沿主要為病原體感染的病因?qū)W說。能引發(fā)CFS的病原體涉及支原體,EB病毒,腸道病毒,伯納特氏立克次體,人類皰疹病毒,腸道革蘭陰性桿菌等,感染后呈現(xiàn)典型的CFS慢性癥狀。3.通過對425例與感染有關(guān)的CFS患者進行調(diào)查發(fā)現(xiàn),其中以男性為主(86.12%),可疑暴露途徑以不安全性行為(商業(yè)性行為、網(wǎng)絡(luò)一夜情)為主(285例,67.06%),該群體的CFS主訴癥狀有嚴重疲勞,頭痛,肌肉痛,關(guān)節(jié)痛,淋巴節(jié)腫大等,涉及皮膚、呼吸道、消化道、骨骼肌肉和神經(jīng)系統(tǒng)等。相關(guān)癥狀與國內(nèi)外報道的由感染引發(fā)的CFS癥狀高度重疊。部分病例提交了臨床檢測分析報告單,其中CD4/CD8比例異常139例(62.61%),與感染/炎癥相關(guān)的白細胞/中性粒細胞/淋巴細胞/單核細胞指標(biāo)異常120例(46.15%)。這些結(jié)果與我們的推論(因不安全性行為導(dǎo)致病原體感染,導(dǎo)致CFS癥狀出現(xiàn))一致。4.45名CFS患者的現(xiàn)場調(diào)查顯示,其個體特征、臨床特點、可疑感染暴露途徑與網(wǎng)絡(luò)調(diào)查結(jié)果一致。其中CD4/CD8比值異常15例(33.33%),PPD陽性(++~+++)16例(35.56%)。與正常人群相比,CFS病例組的血清IgM、IgA、CRP的平均水平顯著增高。證明被觀察人群中存在感染及炎性反應(yīng)的生物學(xué)特點,進一步驗證了研究推論。5.通過對納入CFS患者的32個家庭,51名家屬(父母,配偶,子女,兄妹)進行家庭調(diào)查發(fā)現(xiàn),有25名家屬(49.02%)被診斷為CFS,此外,還有6名家屬(11.76%)被診斷為慢性疲勞狀態(tài)。這些結(jié)果顯示,由感染引發(fā)的CFS病例可能存在家庭聚集現(xiàn)象。
[Abstract]:Since June 2009, the national health sector has received a number of "patients" who believe they have contracted HIV, and developed AIDS-related symptoms after unsafe sex. The Ministry of Health attaches great importance to patients' demands, and organizes relevant departments to conduct counseling and investigation on them. In recent years, a number of research institutions and teams have been actively involved in research. However, the main symptoms of the group tend to deviate from the results of routine clinical tests, which complicates the problem. Psychology theory and pathogen infection theory have become the focus of debate. Our previous observations show that the group features of this population include: severe fatigue, systemic / local muscle joint pain, low fever night sweating, lymphoid ganglion enlargement, pharyngitis, gingival atrophy, tongue coating white greasy, rash and so on. Combined with the results of systematic analysis, the symptoms were similar to those of CFS caused by pathogen infection. Therefore, we intend to use epidemiological investigation method to further observe and describe the characteristics of this "disease" in order to provide a basis for further verification of this hypothesis. The results are as follows: 1. Based on the literature related to CFS published in Web of Science database from 2000 to 2014, the scientific knowledge map related to CFS was drawn by using the visualization software CiteSpace 鈪，

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