慢性疲劳综合征和非慢性疲劳综合征的血流动力学不稳定评分

Hemodynamics instability score in chronic fatigue syndrome and in non-chronic fatigue syndrome.

作者信息

Naschitz Jochanan E, Sabo Edmond, Naschitz Shaul, Rosner Itzhak, Rozenbaum Michael, Fields Madeline, Isseroff Hillel, Priselac Renata Musafia, Gaitini Luis, Eldar Samuel, Zukerman Eli, Yeshurun Daniel

机构信息

Departments of Internal Medicine A, Rheumatology, Anesthesiology, and Surgery, Bnai Zion Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Semin Arthritis Rheum. 2002 Dec;32(3):141-8. doi: 10.1053/sarh.2002.34608.

DOI:10.1053/sarh.2002.34608

PMID:12528078

Abstract

OBJECTIVE

In studying patients with chronic fatigue syndrome (CFS) we developed a method that confers numerical expression to the degree of blood pressure and heart rate lability, ie, the 'hemodynamic instability score' (HIS). The HIS in CFS patients differed significantly from healthy subjects. The present investigation compares the HIS in CFS, non-CFS chronic fatigue and patients with recurrent syncope.

METHODS

Patients with CFS (n = 21), non-CFS chronic fatigue (n = 24), syncope of unknown cause (n = 44), and their age and sex-matched healthy controls (n = 21) were evaluated with a standardized head-up tilt test (HUTT). Abnormal reactions (endpoints) on HUTT were classified 'clinical outcomes' (cardioinhibitory or vasodepressor reaction, orthostatic hypotension, postural tachycardia syndrome) and 'HIS endpoint', i.e. HIS >-0.98.

RESULTS

The highest incidence of endpoints was noted in patients with CFS (79%), followed by patients with syncope of unknown cause (46%), non-CFS chronic fatigue (35%), and healthy subjects (14%). Presyncope or syncope during tilt occurred in 38% of CFS patients, 21% of patients with non-CFS chronic fatigue, and 43% of patients with recurrent syncope. The average HIS values were: CFS = +2.02 (SD 4.07), non-CFS chronic fatigue = -2.89 (SD 3.64), syncope = -3.2 (SD 3.0), healthy = -2.48 (4.07). The odds ratios for CFS patients to have HIS >-0.98 was 8.8 compared with non-CFS chronic fatigue patients, 14.6 compared with recurrent syncope patients, and 34.8 compared with healthy subjects.

CONCLUSION

The cardiovascular reactivity in patients with CFS has certain features in common with the reactivity in patients with recurrent syncope or non-CFS chronic fatigue, such as the frequent occurrence of vasodepressor reaction, cardioinhibitory reaction, and postural tachycardia syndrome. Apart from to these shared responses, the large majority of CFS patients exhibit a particular abnormality which is characterized by HIS values >-0.98. Thus, HIS >-0.98 lends objective criteria to the assessment of CFS.

摘要

目的

在对慢性疲劳综合征（CFS）患者的研究中，我们开发了一种方法，可对血压和心率波动程度进行数值表达，即“血液动力学不稳定评分”（HIS）。CFS患者的HIS与健康受试者有显著差异。本研究比较了CFS、非CFS慢性疲劳和复发性晕厥患者的HIS。

方法

对CFS患者（n = 21）、非CFS慢性疲劳患者（n = 24）、不明原因晕厥患者（n = 44）以及年龄和性别匹配的健康对照者（n = 21）进行标准化直立倾斜试验（HUTT）评估。HUTT上的异常反应（终点）分为“临床结局”（心脏抑制或血管减压反应、直立性低血压、体位性心动过速综合征）和“HIS终点”，即HIS > -0.98。

结果

终点发生率最高的是CFS患者（79%），其次是不明原因晕厥患者（46%）、非CFS慢性疲劳患者（35%）和健康受试者（14%）。倾斜过程中发生前驱晕厥或晕厥的情况在38%的CFS患者、21%的非CFS慢性疲劳患者和43%的复发性晕厥患者中出现。平均HIS值分别为：CFS = +2.02（标准差4.07），非CFS慢性疲劳 = -2.89（标准差3.64），晕厥 = -3.2（标准差3.0），健康 = -2.48（4.07）。CFS患者HIS > -0.98的比值比与非CFS慢性疲劳患者相比为8.8，与复发性晕厥患者相比为14.6，与健康受试者相比为34.8。