Vaerøy Henning, Helle Robert, Førre Øystein, Kåss Erik, Terenius Lars
Dept. of Clinical Rheumatology, Oslo Sanitetsforenings Rheumatism Hospital, University of Oslo, OsloNorway Dept. of Neurology, Ullevål Sykehus, University of Oslo, OsloNorway Dept. of Pharmacology, University of Uppsala, UppsalaSweden.
Pain. 1988 Jan;32(1):21-26. doi: 10.1016/0304-3959(88)90019-X.
In 30 patients with diagnosed fibromyalgia, the CSF level of immunoreactive substance P (SP) was investigated. Compared to normal values (9.6 +/- 3.2 fmol/ml), all the patients had elevated CSF levels of SP (36.1 +/- 2.7 fmol/ml, range 16.5-79.1 fmol/ml). Anamnestic information from the patients revealed that 53.3% had Raynaud/Raynaud-like phenomenon localized in the fingers, the toes or both. Although SP levels did not differ significantly in patients with or without the Raynaud phenomenon, elevated activity may be present in the peripheral branches of SP neurons which could be responsible for the last (rubor) phase of the triphasic Raynaud's phenomenon. SP levels were significantly higher in patients who were smokers (40.1 +/- 2.7 fmol/ml, range 25.3-64.1 fmol/ml), compared to patients who were non-smokers (29.2 +/- 5.0 fmol/ml, range 16.5-79.1 fmol/ml). We propose elevated CSF levels of SP and the Raynaud phenomenon as characteristic features for fibromyalgia with potential as diagnostic markers of the disease and further that smoking might be an aggravating factor for its pathogenesis or development.
对30例已确诊纤维肌痛的患者，研究了其脑脊液中免疫反应性P物质（SP）的水平。与正常值（9.6±3.2飞摩尔/毫升）相比，所有患者的脑脊液SP水平均升高（36.1±2.7飞摩尔/毫升，范围16.5 - 79.1飞摩尔/毫升）。患者的既往信息显示，53.3%的患者有雷诺现象/雷诺样现象，局限于手指、脚趾或两者。虽然有或无雷诺现象的患者SP水平无显著差异，但SP神经元的外周分支可能存在活性升高，这可能是三相雷诺现象最后（红斑）阶段的原因。与非吸烟者（29.2±5.0飞摩尔/毫升，范围16.5 - 79.1飞摩尔/毫升）相比，吸烟者患者的SP水平显著更高（40.1±2.7飞摩尔/毫升，范围25.3 - 64.1飞摩尔/毫升）。我们提出脑脊液SP水平升高和雷诺现象是纤维肌痛的特征性表现，有可能作为该疾病的诊断标志物，并且进一步表明吸烟可能是其发病机制或发展的一个加重因素。
