慢性疲劳综合征病理节律特征研究

The study on pathological rhythm characteristics of chronic fatigue syndrome

目的研究慢性疲劳综合征(CFS)核心体温、心率、血压、唾液皮质醇和褪黑素的昼夜节律特征,探索慢性疲劳综合征病理表现特点。方法对2006年3月至2007年1月成都中医药大学国医堂的20例CFS患者与20名健康受试者进行对照,应用时间生物学的研究方法进行24h核心体温、心率、血压、唾液皮质醇和褪黑素的动态检测,采用余弦分析法进行节律分析,以SPSS10.0统计软件重复测量资料方差进行组间差异分析。结果健康组所有指标都具有昼夜节律(P<0.05),CFS组除舒张压节律消失(P>0.05)外,其余各项指标具有昼夜节律(P<0.05),但昼夜节律振幅明显低于健康组,核心体温、心率、血压和褪黑素的峰值相位后移而皮质醇的峰值相位超前;重复测量资料方差分析,分组因素主效应差异无统计学意义(P>0.05)。结论CFS具有明显的昼夜节律紊乱现象,但与健康组比较各项指标在总体水平差异无统计学意义,CFS昼夜节律的紊乱是其基本的病理特征。

Objective To study the circadian rhythms of the core temperature, blood pressure, heart rate, cortisol and melatonin of the patients with chronic fatigue syndrome and to explore the pathologic characteristics of CFS. Methods The core body temperature, blood pressure,heart rate, cortisol and melatonin from 20 CFS patients and 20 normal controls were estimated by the chronobiologic research method. The circadian rhythms were analyzed by cosinor and Repeated Measures of SPSS 10.0. Results The core temperature,heart rate,blood pressure, cortisol and melatonin of the normal controls had their own circadian rhythms （ P〈0.05 ）. While the indexes of CFS group also showed their own circadian rhythms （ P〈0.05）except the diastolic blood pressure （P〉0. 05 ）. The circadian rhythm amplitudes of all indexes of the CFS group were lower than that of the control group. The acrophase of the core body temperature, heart rate, blood pressure and melatonin of the CFS group were delayed, while acrophase of cortisol was a little forward. The above-mentioned figures of six items were tested, but there was no significant difference among these groups （ P〉0.05 ）. Conclusion The patients with CFS show a disorder of circadian rhythm. However, each index of CFS has no significant difference on the overall level. The imbalance of circadian rhythm is the pathologic characteristic of CFS.