慢性疲劳综合征肌肉病理生理的Scoping综述OA

Objective To systematically summarize the relevant pathophysiology underlying muscle fatigue in myalgic encephalo-myelitis/chronic fatigue syndrome(ME/CFS). Methods Databases including PubMed,Web of Science Core Collection,Embase,Cochrane Library,EBSCO(CI-NAHL),CNKI,Wanfang Data and VIP Database were searched from their inception to July,2025 for basic and clinical studies related to ME/CFS.Multidimensional evidence involving mitochondrial,neuromuscular junction dysfunction,autonomic dysregulation and immune-inflammatory responses was integrated.The role of muscles in the central-immune-metabolic-neural regulatory network and its association with clinical phenotypes were evaluated. Results Patients with ME/CFS commonly presented with impaired mitochondrial energy supply,oxidative stress,ion ho-meostasis disorders,reduced stability of neuromuscular junction transmission,insufficient central drive and pos-tural intolerance.These abnormalities resulted in a predisposition to cross the anaerobic threshold and trigger post-exertional malaise. Conclusion Muscle pathophysiology plays a critical role in the pathogenesis and symptom persistence of ME/CFS.Re-habilitation practice should prioritize safety boundaries to avoid post-exertional malaise.