Demitrack M A, Gold P W, Dale J K, Krahn D D, Kling M A, Straus S E
Department of Psychiatry, University of Michigan Medical Center, Ann Arbor 48109-0116.
Biol Psychiatry. 1992 Dec 15;32(12):1065-77. doi: 10.1016/0006-3223(92)90187-5.
The syndrome of chronic fatigue, feverishness, diffuse pains, and other constitutional complaints, often precipitated by an acute infectious illness and aggravated by physical and emotional stressors, has a lengthy history in the medical literature. The Centers for Disease Control (CDC) recently formulated a case definition, renaming the illness "chronic fatigue syndrome." Nevertheless, there remain few biological data that can validate the existence of this syndrome as distinct from a wide variety of other, largely psychiatric disorders, and little understanding of its pathogenesis. In the present study, basal plasma and cerebrospinal fluid levels of the monoamine metabolites, 3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA) were determined in 19 patients meeting CDC research case criteria for chronic fatigue syndrome and in 17 normal individuals. Patients with chronic fatigue syndrome showed a significant reduction in basal plasma levels of MHPG and a significant increase in basal plasma levels of 5-HIAA. Although the functional significance of these findings has not been definitively elucidated, they are compatible with the clinical presentation of a syndrome associated with chronic lethargy and fatigue, and with evidence of persistent immune stimulation, and lend support to the idea that chronic fatigue syndrome represents a clinical entity with potential biological specificity.
慢性疲劳、发热、全身疼痛及其他全身性不适症状的综合征，常由急性感染性疾病引发，并因身体和情绪压力因素而加重，在医学文献中有很长的历史。疾病控制中心（CDC）最近制定了病例定义，将这种疾病重新命名为“慢性疲劳综合征”。然而，几乎没有生物学数据能够证实该综合征的存在有别于其他多种主要为精神性的疾病，对其发病机制也知之甚少。在本研究中，测定了19例符合CDC慢性疲劳综合征研究病例标准的患者及17名正常个体的单胺代谢产物3 - 甲氧基 - 4 - 羟基苯乙二醇（MHPG）、5 - 羟吲哚乙酸（5 - HIAA）和高香草酸（HVA）的基础血浆和脑脊液水平。慢性疲劳综合征患者的基础血浆MHPG水平显著降低，基础血浆5 - HIAA水平显著升高。尽管这些发现的功能意义尚未得到明确阐明，但它们与一种与慢性嗜睡和疲劳相关的综合征的临床表现相符，也与持续免疫刺激的证据相符，并支持慢性疲劳综合征代表一种具有潜在生物学特异性的临床实体这一观点。
