CHRONIC FATIGUE SYNDROME STUDIES ON CLINICAL …慢性疲劳综合征的临床的研究….pptVIP

* * * * * * * * * * * * * * * Myalgic encephalomyelitis: A highly prevalent debilitating disease Persistent, debilitating fatigue associated with numerous physical and neurocognitive symptoms Disease severity can range from moderate to extremely severe: patients bedridden for years, totally caregiver dependent Prevalence estimates: 0,3 to 0,6%; one million patients in the USA, two million patients in Europe This may just be the tip of the iceberg High socio-economic cost Cost to the society estimated as approximately $16 billion in the USA, €20 billion in Europe Patients usually present with multiple intestinal symptoms including: Nausea Abdominal pain Poor appetite Abnormal bowel motility Gastric reflux Bloating Inflammation of the gastrointestinal tract Marked alteration of the intestinal microbial flora Intestinal disorders in ME patients Enterococcus and Streptococcus species are strongly over-represented in ME patients : Organisms Control ME patients p-value E.coli 1.0 x 108 4.26 x 107 p=0.98 Enterococcus spp. 5.0 x 106 3.5 x 107 p0.001 Streptococcus spp. 8.9 x 104 9.8 x 107 p0.001 Henry Butt, University of Melbourne Alterations of intestinal microflora (aerobes) Among anaerobic bacteria, Prevotella is the most consistently overgrown bacteria : Henry Butt, University of Melbourne Organisms Control ME patients p-value Bacteroides spp. 3.2 x 1011 1.6 x 1011 p=0.39 Prevotella spp. 1.0 X 108 9.0 x 109 p 0.001 Bifidobacterium spp. 6.0 x 108 5.5 x 109 p=0.001 Lactobacillus spp. 2.7 x 107 1.8 x 108 p=0.002 Alterations of intestinal microflora (anaerobes) Henry Butt, University of Melbourne Symptoms r and p-values Headache r=.17, p0.01 Arm pain r=.20, p0.003 Shoulder pain r=.15, p0.04 Myalgia r=.20, p0.003 Palpitations r=.16, p0.02 Sleep disturbance r=.20, p0.004 Enterococcus spp. counts correlate with symptom expression : Bacterial overgrowth correlates with symptoms severity Henry Butt, University of Melbourne Streptococ