Maliszewski Anne M, Goldenberg Don L, Hurwitz Shelley, Adler Gail K
Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Rheumatol. 2002 Jul;29(7):1482-7.
To assess the function of the renin-angiotensin-aldosterone (RAA) system in women with fibromyalgia (FM) compared to healthy women.
Women with FM [n = 14, age 41.0+/-7.2 yrs, body mass index (BMI) 26.4+/-5.4 kg/m2] and healthy women (n = 13, age 40.0+/-7.7 yrs, BMI 25.0+/-5.0 kg/m2) were placed on a low sodium diet (10 mEq sodium/day) for 5 days. After being supine and fasting overnight, subjects received an intravenous infusion of angiotensin II at successive doses of 1, 3, and 10 ng/kg/min for 45 min per dose. Blood pressure (BP), plasma renin activity (PRA), aldosterone, and cortisol were measured at baseline and after each dose of angiotensin II. Prior to sodium restriction, women with FM completed the Hopkins Symptom Checklist-90, which included a question grading the extent of dizziness/faintness on a scale of 0 (none) to 4 (extremely).
After dietary sodium restriction, baseline PRA, aldosterone, and supine BP were similar in healthy women and women with FM. Aldosterone and BP rose in response to infused angiotensin II; these responses did not differ significantly between healthy women and women with FM. In women with FM, symptoms of dizziness correlated inversely with BMI (r = -0.81, p < 0.001) and the systolic BP response to 10 ng/kg/min angiotensin II (r = -0.81, p < 0.001).
The functioning of the RAA system, including the vascular response to angiotensin II, was intact in women with FM compared to healthy women. However, women with FM who complained of dizziness had a blunted vascular response to angiotensin II. This blunted vascular response may indicate intravascular volume depletion in women with symptoms of dizziness.
评估与健康女性相比，纤维肌痛（FM）女性患者肾素 - 血管紧张素 - 醛固酮（RAA）系统的功能。
将FM女性患者[ n = 14，年龄41.0±7.2岁，体重指数（BMI）26.4±5.4kg/m²]和健康女性（n = 13，年龄40.0±7.7岁，BMI 25.0±5.0kg/m²）置于低钠饮食（10mEq钠/天）5天。在过夜仰卧禁食后，受试者接受静脉输注血管紧张素II，剂量依次为1、3和10ng/kg/min，每剂输注45分钟。在基线以及每剂血管紧张素II输注后测量血压（BP）、血浆肾素活性（PRA）、醛固酮和皮质醇。在限制钠摄入之前，FM女性患者完成了霍普金斯症状清单 - 90，其中包括一个问题，该问题以0（无）至4（极其严重）的等级对头晕/昏厥程度进行评分。
饮食限制钠摄入后，健康女性和FM女性患者的基线PRA、醛固酮和仰卧位BP相似。醛固酮和BP随输注的血管紧张素II而升高；健康女性和FM女性患者之间的这些反应无显著差异。在FM女性患者中，头晕症状与BMI呈负相关（r = -0.81，p < 0.001）以及与对10ng/kg/min血管紧张素II的收缩压反应呈负相关（r = -0.81，p < 0.001）。
与健康女性相比，FM女性患者的RAA系统功能，包括对血管紧张素II的血管反应是完整的。然而，抱怨头晕的FM女性患者对血管紧张素II的血管反应减弱。这种减弱的血管反应可能表明有头晕症状的女性患者存在血管内容量减少。
