Davis S D, Kator S F, Wonnett J A, Pappas B L, Sall J L
Preventive Medicine, Evans US Army Community Hospital, Fort Carson, Colorado, USA.
Am J Med Sci. 2000 Feb;319(2):89-95. doi: 10.1097/00000441-200002000-00004.
Many patients with chronic fatigue syndrome (CFS) have neurally mediated hypotension when subjected to head-up tilt, suggesting autonomic nervous system dysfunction. Some Gulf War veterans have symptoms similar to CFS. Whether they also tend to have neurally mediated hypotension is unknown.
We performed 3-stage tilt-table testing on 14 Gulf War veterans with chronic fatigue, 13 unfatigued control Gulf War veterans, and 14 unfatigued control subjects who did not serve in the Gulf War. Isoproterenol was used in stages 2 and 3 of the tilt protocol.
More fatigued Gulf War veterans than unfatigued control subjects had hypotensive responses to tilt (P < 0.036). A positive response to the drug-free stage 1 of the tilt was observed in 4 of 14 fatigued Gulf War veterans versus 1 of 27 unfatigued control subjects (P < 0.012). Heart rate and heart rate variation during stage 1 was significantly greater in the fatigued group (P < 0.05).
We conclude that more fatigued Gulf War veterans have neurally mediated hypotension than unfatigued control subjects, similar to observations in CFS. Autonomic nervous system dysfunction may be present in some fatigued Gulf War veterans.
许多慢性疲劳综合征（CFS）患者在进行头高位倾斜试验时会出现神经介导性低血压，提示自主神经系统功能障碍。一些海湾战争退伍军人有类似于CFS的症状。他们是否也容易出现神经介导性低血压尚不清楚。
我们对14名患有慢性疲劳的海湾战争退伍军人、13名无疲劳症状的海湾战争退伍军人对照组以及14名未参加过海湾战争的无疲劳症状受试者进行了三阶段倾斜试验。在倾斜试验的第2和第3阶段使用异丙肾上腺素。
与无疲劳症状的对照组相比，更多患有疲劳症状的海湾战争退伍军人在倾斜试验时出现低血压反应（P < 0.036）。在14名患有疲劳症状的海湾战争退伍军人中，有4人在倾斜试验的无药第1阶段出现阳性反应，而在27名无疲劳症状的对照组受试者中只有1人出现阳性反应（P < 0.012）。疲劳组在第1阶段的心率和心率变异性显著更高（P < 0.05）。
我们得出结论，与无疲劳症状的对照组相比，更多患有疲劳症状的海湾战争退伍军人存在神经介导性低血压，这与CFS中的观察结果相似。一些患有疲劳症状的海湾战争退伍军人可能存在自主神经系统功能障碍。
