Sietsema K E, Cooper D M, Caro X, Leibling M R, Louie J S
Department of Medicine, Harbor-UCLA Medical Center, Torrance 90509.
J Rheumatol. 1993 May;20(5):860-5.
Muscle ischemia has been postulated as a causative factor in pain and disability in patients with primary fibromyalgia syndrome (PFS) and previous studies have demonstrated that patients with PFS have reduced maximum oxygen uptake (VO2). Our objective was to examine the level and pattern of VO2 in response to graded exercise and defined levels of constant work rate exercise in patients with PFS.
Unmedicated patients fulfilling modified Yunus' criteria for the diagnosis of PFS and healthy control subjects performed upright cycle ergometry exercise with measurements of respiratory gas exchange and grading of pain using visual analog scores.
Patients, but not controls, had significantly higher levels of pain after graded exercise than before exercise. Although peak VO2 did not differ between the 2 groups, effort dependent variables of exercise function were more variable in the patients than in control subjects. The onset of muscle anaerobiosis as reflected in respiratory gas exchange, the relationship between VO2 and work rate throughout the range of exercise work rates, and the mean response time for the increase in VO2 to the exercise level in response to a constant work rate of exercise were not different for patients compared to controls.
Despite the subjective reports of pain, our studies demonstrate no abnormality in the overall rate and pattern of utilization of oxygen during muscular exercise in patients with PFS.
肌肉缺血被认为是原发性纤维肌痛综合征(PFS)患者疼痛和功能障碍的一个致病因素,先前的研究表明PFS患者的最大摄氧量(VO2)降低。我们的目的是研究PFS患者在分级运动和固定工作率运动的特定水平下VO2的水平和模式。
符合修改后的尤努斯PFS诊断标准的未用药患者和健康对照者进行直立式自行车测力计运动,同时测量呼吸气体交换并使用视觉模拟评分法对疼痛进行分级。
分级运动后,患者而非对照组的疼痛水平显著高于运动前。虽然两组之间的峰值VO2没有差异,但患者运动功能的用力相关变量比对照者更具变异性。从呼吸气体交换反映出的肌肉无氧代谢的起始、在整个运动工作率范围内VO2与工作率之间的关系,以及在固定工作率运动时VO2增加到运动水平的平均反应时间,患者与对照者相比并无差异。
尽管有疼痛的主观报告,但我们的研究表明PFS患者在肌肉运动期间氧气利用的总体速率和模式并无异常。