Maselli R A, Jaspan J B, Soliven B C, Green A J, Spire J P, Arnason B G
Department of Neurology, University of Chicago, IL 60637.
Muscle Nerve. 1989 May;12(5):420-3. doi: 10.1002/mus.880120513.
The sympathetic skin response (SSR), the quantitative sudomotor axon reflex test (Q-SART), and cardiac beat-to-beat variability with respiration as measured by the expiratory/inspiratory ratio (E/I ratio) were studied in 39 patients with diabetic neuropathy of whom 33 also had one or more symptoms of autonomic involvement. In the lower extremities 87% of the patients with an absent SSR had an abnormal Q-SART (P less than 0.001), and 81% of patients with the SSR present had a normal Q-SART (P less than 0.02). The E/I ratio was abnormal in all but one of 23 patients with an absent SSR in the foot, and a normal E/I ratio was present only in those patients (n = 7) with the SSR present in hand and foot, and in an eighth patient who had SSR absent in the foot and present in the hand. A similar correlation was found between the E/I ratio and the Q-SART in the foot, although 4 of 25 patients with an abnormal foot Q-SART had a normal E/I ratio. We conclude that the concordance of results of the SSR and Q-SART supports the combined use of these tests to uncover early distal sympathetic failure in diabetic neuropathy.
对39例糖尿病性神经病变患者进行了研究，其中33例还伴有一种或多种自主神经受累症状，检测了他们的交感神经皮肤反应（SSR）、定量汗腺运动轴突反射试验（Q-SART）以及通过呼气/吸气比（E/I比）测量的呼吸引起的逐搏心率变异性。在下肢，SSR消失的患者中87%的Q-SART异常（P<0.001），SSR存在的患者中81%的Q-SART正常（P<0.02）。足部SSR消失的23例患者中，除1例患者外，其余患者的E/I比均异常，仅在手足SSR均存在的患者（n = 7）以及足部SSR消失而手部SSR存在的第8例患者中E/I比正常。足部的E/I比与Q-SART之间也发现了类似的相关性，尽管足部Q-SART异常的25例患者中有4例E/I比正常。我们得出结论，SSR和Q-SART结果的一致性支持联合使用这些测试来发现糖尿病性神经病变早期的远端交感神经功能衰竭。
