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首页> 美国卫生研究院文献>Healthcare >Cerebral Blood Flow Is Reduced in Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients During Mild Orthostatic Stress Testing: An Exploratory Study at 20 Degrees of Head-Up Tilt Testing
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Cerebral Blood Flow Is Reduced in Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients During Mild Orthostatic Stress Testing: An Exploratory Study at 20 Degrees of Head-Up Tilt Testing

机译：轻度体位压力测试期间严重的肌病性脑脊髓炎/慢性疲劳综合症患者的脑血流量减少：20度抬头倾斜测试的探索性研究

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Introduction: In a study of 429 adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), we demonstrated that 86% had symptoms of orthostatic intolerance in daily life. Using extracranial Doppler measurements of the internal carotid and vertebral arteries during a 30-min head-up tilt to 70 degrees, 90% had an abnormal reduction in cerebral blood flow (CBF). A standard head-up tilt test of this duration might not be tolerated by the most severely affected bed-ridden ME/CFS patients. This study examined whether a shorter 15-min test at a lower 20 degree tilt angle would be sufficient to provoke reductions in cerebral blood flow in severe ME/CFS patients. Methods and results: Nineteen severe ME/CFS patients with orthostatic intolerance complaints in daily life were studied: 18 females. The mean (SD) age was 35(14) years, body surface area (BSA) was 1.8(0.2) m and BMI was 24.0(5.4) kg/m . The median disease duration was 14 (IQR 5–18) years. Heart rate increased, and stroke volume index and end-tidal CO decreased significantly during the test ( ranging from <0.001 to <0.0001). The cardiac index decreased by 26(7)%: < 0.0001. CBF decreased from 617(72) to 452(63) mL/min, a 27(5)% decline. All 19 severely affected ME/CFS patients met the criteria for an abnormal CBF reduction. Conclusions: Using a less demanding 20 degree tilt test for 15 min in severe ME/CFS patients resulted in a mean CBF decline of 27%. This is comparable to the mean 26% decline previously noted in less severely affected patients studied during a 30-min 70 degree head-up tilt. These observations have implications for the evaluation and treatment of severely affected individuals with ME/CFS.
机译：简介：在对429名患有肌性脑脊髓炎/慢性疲劳综合症（ME / CFS）的成年人的研究中，我们证明86％的人在日常生活中有体位性不耐症的症状。在颅内多普勒测量中，在抬头倾斜30分钟至70度的过程中，对颈内动脉和椎动脉的测量发现，有90％的人脑血流量（CBF）异常减少。受此病困扰最严重的卧床ME / CFS患者可能无法忍受这种持续时间的标准抬头倾斜测试。这项研究检查了在较低的20度倾斜角下进行较短的15分钟测试是否足以引起严重的ME / CFS患者脑血流量的减少。方法和结果：研究了19名重度ME / CFS患者在日常生活中存在立位不耐症，其中包括18名女性。平均（SD）年龄为35（14）岁，身体表面积（BSA）为1.8（0.2）m，BMI为24.0（5.4）kg / m。中位疾病持续时间为14年（IQR 5-18）。在测试期间，心率增加，中风量指数和潮气末CO显着降低（范围从<0.001到<0.0001）。心脏指数下降26（7）％：<0.0001。 CBF从617（72）降至452（63）mL / min，下降27（5）％。所有19名严重受影响的ME / CFS患者均符合异常CBF降低的标准。结论：在重度ME / CFS患者中使用要求较低的20度倾斜试验15分钟可导致CBF平均下降27％。这相当于先前在30分钟70度抬头俯仰期间受较不严重影响的患者中观察到的平均26％下降。这些发现对ME / CFS严重受影响的个体的评估和治疗具有影响。

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