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肢端肥大症男性患者自主神经系统的电生理评估。

Electrophysiological assessment of the autonomic nervous system in male patients with acromegaly.

机构信息

Department of Neurology, Gülhane Military Medical Academy, General Tevfik Sağlam Street 1, Etlik, Ankara, Turkey.

出版信息

Eur Neurol. 2011;66(1):1-5. doi: 10.1159/000328025. Epub 2011 Jun 1.

DOI:10.1159/000328025
PMID:21646783
Abstract

BACKGROUND/AIMS: We aimed to electrophysiologically evaluate the autonomic function in acromegalic patients using sympathetic skin response (SSR) as a reflection of the sympathetic sudomotor activity and RR interval variation (RRIV) as an indicator of the cardiovagal autonomic function.

METHODS

The study group consisted of 18 male acromegalics, and the control group was composed of 18 age- and sex-matched healthy subjects. Participants underwent SSR and RRIV tests. Beginning latencies and amplitudes of the median and tibial SSRs were compared among the groups. The RRIV values recorded at rest and during hyperventilation were compared among the patients and controls.

RESULTS

Latencies of SSRs recorded from the palms (median) and soles (tibial) of acromegalics were significantly longer than in healthy subjects (p = 0.004, p < 0.001). The amplitude of SSR recorded from the sole (tibial) was significantly decreased (p = 0.028). The RRIVs obtained from acromegalics at rest and during hyperventilation were significantly decreased compared with those of controls (p < 0.001). The RRIVs obtained from controls prolonged significantly during hyperventilation (p < 0.001); however, in the acromegaly group, hyperventilation did not cause a significant change in RRIV (p = 0.983).

CONCLUSIONS

The present study suggests that an autonomic dysfunction exists in patients with acromegaly. Dysautonomia in acromegalics may be documented by means of SSR and RRIV.

摘要

背景/目的:我们旨在通过交感皮肤反应(SSR)评估肢端肥大症患者的自主神经功能,SSR 反映交感神经的泌汗活动,RR 间期变化(RRIV)作为心脏迷走神经自主功能的指标。

方法

研究组包括 18 名男性肢端肥大症患者,对照组由 18 名年龄和性别匹配的健康受试者组成。参与者接受了 SSR 和 RRIV 测试。比较了各组正中神经和胫神经 SSR 的起始潜伏期和振幅。比较了患者和对照组在休息和过度通气时 RRIV 值。

结果

肢端肥大症患者手掌(正中神经)和脚底(胫神经)记录的 SSR 潜伏期明显长于健康受试者(p = 0.004,p < 0.001)。胫神经 SSR 记录的振幅明显降低(p = 0.028)。与对照组相比,肢端肥大症患者在休息和过度通气时的 RRIV 明显降低(p < 0.001)。对照组在过度通气时 RRIV 明显延长(p < 0.001);然而,在肢端肥大症组中,过度通气并没有导致 RRIV 发生显著变化(p = 0.983)。

结论

本研究表明,肢端肥大症患者存在自主神经功能障碍。SSR 和 RRIV 可记录肢端肥大症患者的自主神经功能障碍。

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