LaManca J J, Peckerman A, Walker J, Kesil W, Cook S, Taylor A, Natelson B H
CFS Cooperative Research Center, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA.
Clin Physiol. 1999 Mar;19(2):111-20. doi: 10.1046/j.1365-2281.1999.00154.x.
This study examined the cardiovascular response to orthostatic challenge, and incidence and mechanisms of neurally mediated hypotension in chronic fatigue syndrome (CFS) during a head-up tilt test. Stoke volume was obtained by a thoracic impedance cardiograph, and continuous heart rate and blood pressure were recorded during a 45-min 70 degrees head-up tilt test. Thirty-nine CFS patients and 31 healthy physically inactive control subjects were studied. A positive tilt, i.e. a drop in systolic blood pressure of > 25 mmHg, no concurrent increase in heart rate and/or development of presyncopal symptoms, was seen in 11 CFS patients and 12 control subjects (P > 0.05). During baseline and the first 5 min of head-up tilt, CFS patients had higher heart rate and smaller pulsatile-systolic area than control subjects (P < 0.05). Among subjects who completed the test, those with CFS had higher heart rate and smaller stroke volume (P < 0.05) than corresponding control subjects. When comparing those who had a positive test outcome in each group, CFS patients had higher heart rates and lower pulse pressure and pulsatile-systolic areas during the last 4 min before being returned to supine (P < 0.05). These data show that there are baseline differences in the cardiovascular profiles of CFS patients when compared with control subjects and that this profile is maintained during head-up tilt. However, the frequency of positive tilts and the haemodynamic adjustments made to this orthostatic challenge are not different between groups.
本研究在头高位倾斜试验中，检测了慢性疲劳综合征（CFS）患者对直立位应激的心血管反应、神经介导性低血压的发生率及机制。通过胸阻抗心动图获得每搏输出量，并在45分钟70度头高位倾斜试验期间连续记录心率和血压。对39例CFS患者和31例健康的缺乏运动的对照受试者进行了研究。11例CFS患者和12例对照受试者出现阳性倾斜，即收缩压下降>25 mmHg，心率无同时增加和/或未出现晕厥前症状（P>0.05）。在基线期和头高位倾斜的最初5分钟内，CFS患者的心率高于对照受试者，搏动性收缩面积小于对照受试者（P<0.05）。在完成试验的受试者中，CFS患者的心率高于相应的对照受试者，每搏输出量小于对照受试者（P<0.05）。比较每组中试验结果为阳性的受试者时，CFS患者在恢复仰卧位前的最后4分钟内心率更高，脉压和搏动性收缩面积更低（P<0.05）。这些数据表明，与对照受试者相比，CFS患者的心血管特征在基线期存在差异，且在头高位倾斜期间这种特征得以维持。然而，两组之间阳性倾斜的频率以及对这种直立位应激所做的血流动力学调整并无差异。
