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[纤维肌痛综合征患者的压力与自主神经调节异常]

[Stress and autonomic dysregulation in patients with fibromyalgia syndrome].

作者信息

Friederich H-C, Schellberg D, Mueller K, Bieber C, Zipfel S, Eich W

机构信息

Allgemeine Klinische und Psychosomatische Medizin, Medizinische Klinik und Poliklinik der Universität Heidelberg.

出版信息

Schmerz. 2005 Jun;19(3):185-8, 190-2, 194. doi: 10.1007/s00482-004-0335-1.

Abstract

AIM

The aim of the present study was to evaluate to what extent the orthostatic dysregulation of FMS patients can be attributed primarily to reduced baroreceptor-mediated activation of the sympathetic nervous system and whether a hyporeactive sympathetic nervous system can also be confirmed for mental stress.

PATIENTS AND METHODS

A total of 28 patients with primary FMS were examined and compared with 15 healthy subjects. Diagnostic investigations of the autonomic nervous system were based on measuring HRV in frequency range and assessing spontaneous baroreflex sensitivity (sBRS) under mental stress and passive orthostatism.

RESULTS

Both under orthostatic and mental stress FMS patients exhibited reduced activation of the sympathetic nervous system as measured by the spectral power of HRV in the low-frequency range and the mean arterial blood pressure or heart rate. The present study provided no indications for dysregulation of sBRS.

CONCLUSION

The results obtained confirm the hypothesis of a hyporeactive stress system in FMS patients for both peripherally and centrally mediated stimulation of the sympathetic nervous system.

摘要

目的

本研究旨在评估纤维肌痛综合征(FMS)患者的直立性调节障碍在多大程度上可主要归因于压力感受器介导的交感神经系统激活减少,以及对于精神应激是否也能证实存在反应性低下的交感神经系统。

患者与方法

共检查了28例原发性FMS患者,并与15名健康受试者进行比较。自主神经系统的诊断研究基于测量频率范围内的心率变异性(HRV)以及评估精神应激和被动直立状态下的自发压力反射敏感性(sBRS)。

结果

在直立和精神应激状态下,通过低频范围内HRV的频谱功率以及平均动脉血压或心率测量,FMS患者均表现出交感神经系统激活减少。本研究未发现sBRS调节异常的迹象。

结论

所获得的结果证实了FMS患者存在反应性低下的应激系统这一假设,无论是对于外周和中枢介导的交感神经系统刺激。

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