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静态肌肉收缩对健康个体和纤维肌痛患者的血压、心率、疼痛评分及压力疼痛阈值的影响。

The effects of static muscular contraction on blood pressure, heart rate, pain ratings and pressure pain thresholds in healthy individuals and patients with fibromyalgia.

作者信息

Kadetoff Diana, Kosek Eva

机构信息

Section of Clinical Pain Research, Department of Surgical Sciences, Karolinska Institute, Stockholm, Sweden.

出版信息

Eur J Pain. 2007 Jan;11(1):39-47. doi: 10.1016/j.ejpain.2005.12.013. Epub 2006 Feb 9.

Abstract

Aberrations of cardiovascular regulation and dysfunction of endogenous pain modulation have been reported in fibromyalgia (FM) patients. This study aimed at investigating the interactions between cardiovascular regulation and pain perception during static muscle contractions. Seventeen FM patients and 17 healthy controls performed a standardised static contraction (m. quadriceps femoris dx) until exhaustion. Blood pressure (BP), heart rate (HR), ratings of exertion/fatigue and pain intensity as well as pressure pain thresholds (PPTs) (at m. quadriceps dx and m. deltoideus dx) were assessed before, during and 15 min following contraction. Systolic and diastolic BP increased during contraction (p<0.001) and decreased following contraction (p<0.001) in both groups alike. A significant increase in HR was seen during contraction in FM patients (p<0.001), but not in healthy controls (difference between groups p<0.02). The rated exertion/fatigue and pain intensity increased more during contraction and remained elevated longer following contraction in the patient group. PPTs were lower in patients compared to controls at both sites at all times (p<0.001). No group differences in PPT changes over time were found. In conclusion, no indication of an attenuated cardiovascular response to exercise was found in our FM patients. The more pronounced HR increase in patients during contraction was most likely due to deconditioning. No exercise related change in PPTs was seen in either group, most likely due to insufficient exercise intensity, but the contraction induced pain was more pronounced in the FM patients.

摘要

据报道,纤维肌痛(FM)患者存在心血管调节异常和内源性疼痛调节功能障碍。本研究旨在调查静态肌肉收缩期间心血管调节与疼痛感知之间的相互作用。17名FM患者和17名健康对照者进行标准化的静态收缩(右侧股四头肌)直至力竭。在收缩前、收缩期间和收缩后15分钟评估血压(BP)、心率(HR)、用力/疲劳评分和疼痛强度以及压力疼痛阈值(PPTs)(右侧股四头肌和右侧三角肌处)。两组收缩期间收缩压和舒张压均升高(p<0.001),收缩后均降低(p<0.001)。FM患者收缩期间HR显著增加(p<0.001),而健康对照者则无增加(组间差异p<0.02)。患者组在收缩期间用力/疲劳评分和疼痛强度增加更多,收缩后持续升高时间更长。患者在两个部位的PPTs在所有时间均低于对照组(p<0.001)。未发现两组PPTs随时间变化的差异。总之,在我们的FM患者中未发现心血管对运动反应减弱的迹象。患者在收缩期间HR增加更明显很可能是由于身体机能下降。两组均未观察到与运动相关的PPTs变化,很可能是由于运动强度不足,但收缩诱发的疼痛在FM患者中更明显。

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