Park J H, Phothimat P, Oates C T, Hernanz-Schulman M, Olsen N J
Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2681, USA.
Arthritis Rheum. 1998 Mar;41(3):406-13. doi: 10.1002/1529-0131(199803)41:3<406::AID-ART5>3.0.CO;2-L.
To investigate the metabolic and functional status of muscles of fibromyalgia (FM) patients, using P-31 magnetic resonance spectroscopy (MRS).
Twelve patients with FM and 11 healthy subjects were studied. Clinical status was assessed by questionnaire. Biochemical status of muscle was evaluated with P-31 MRS by determining concentrations of inorganic phosphate (Pi), phosphocreatine (PCr), ATP, and phosphodiesters during rest and exercise. Functional status was evaluated from the PCr/Pi ratio, phosphorylation potential (PP), and total oxidative capacity (Vmax).
Patients with FM reported greater difficulty in performing activities of daily living as well as increased pain, fatigue, and weakness compared with controls. MRS measurements showed that patients had significantly lower than normal PCr and ATP levels (P < 0.004) and PCr/Pi ratios (P < 0.04) in the quadriceps muscles during rest. Values for PP and Vmax also were significantly reduced during rest and exercise.
P-31 MRS provides objective evidence for metabolic abnormalities consistent with weakness and fatigue in patients with FM. Noninvasive P-31 MRS may be useful in assessing clinical status and evaluating the effectiveness of treatment regimens in FM.
采用磷-31磁共振波谱（MRS）研究纤维肌痛（FM）患者肌肉的代谢和功能状态。
对12例FM患者和11名健康受试者进行研究。通过问卷调查评估临床状态。利用磷-31 MRS，通过测定静息和运动期间无机磷酸盐（Pi）、磷酸肌酸（PCr）、三磷酸腺苷（ATP）和磷酸二酯的浓度来评估肌肉的生化状态。从PCr/Pi比值、磷酸化电位（PP）和总氧化能力（Vmax）评估功能状态。
与对照组相比，FM患者报告在进行日常生活活动时困难更大，疼痛、疲劳和虚弱感增加。MRS测量显示，静息时患者股四头肌中的PCr和ATP水平显著低于正常水平（P < 0.004），PCr/Pi比值也显著降低（P < 0.04）。静息和运动期间PP和Vmax值也显著降低。
磷-31 MRS为FM患者与虚弱和疲劳相关的代谢异常提供了客观证据。无创性磷-31 MRS可能有助于评估FM患者的临床状态和评价治疗方案的有效性。
