Staud Roland
Department of Medicine, University of Florida College of Medicine, PO Box 100221, D2-39, Gainesville, FL 32610, USA.
Curr Rheumatol Rep. 2008 Dec;10(6):463-6. doi: 10.1007/s11926-008-0076-8.
Although fibromyalgia (FM) syndrome is defined by chronic widespread pain and tenderness, additional symptoms, including disabling fatigue and dizziness, are often reported by patients with this chronic illness. Although nonrestorative sleep may play an important role for chronic fatigue in FM, other mechanisms, including dysfunction of the autonomic nervous system (ANS), need to be considered. Many important biological functions, such as heart rate, blood pressure, respirations, and bowel function, are tightly regulated by the ANS. However, dysfunction of the ANS is common in FM and often becomes quite apparent after positional changes from supine to upright. Although such positional changes sometimes result in syncope, they are more often associated with palpitations and dizziness. Head-up tilt table testing can be used to evaluate autonomic dysfunction and is frequently helpful for the work-up of FM complaints, including fatigue, dizziness, and palpitations. One of the most common events experienced by FM patients during tilt table testing is postural orthostatic tachycardia syndrome, which is defined as a heart rate increase of more than 30 beats per minute after more than 3 minutes of standing upright.
尽管纤维肌痛（FM）综合征以慢性广泛性疼痛和压痛为特征，但患有这种慢性病的患者常报告有其他症状，包括致残性疲劳和头晕。虽然非恢复性睡眠可能在FM的慢性疲劳中起重要作用，但其他机制，包括自主神经系统（ANS）功能障碍，也需要考虑。许多重要的生物学功能，如心率、血压、呼吸和肠道功能，都受ANS的严格调节。然而，ANS功能障碍在FM中很常见，并且在从仰卧位变为直立位后往往变得很明显。虽然这种体位变化有时会导致晕厥，但它们更常与心悸和头晕有关。头高位倾斜试验可用于评估自主神经功能障碍，并且常常有助于对FM相关症状（包括疲劳、头晕和心悸）进行检查。FM患者在倾斜试验中最常经历的事件之一是体位性直立性心动过速综合征，其定义为直立站立超过3分钟后心率每分钟增加超过30次。
