Barkai L, Madácsy L, Vincze P
Orv Hetil. 1989 Sep 17;130(38):2037-40.
The authors investigated the preclinical signs of autonomic neuropathy (resting heart rate, hyperventilatory arrhythmia, heart rate on standing/lying, orthostatic blood-pressure decrease) in 15 type I diabetic children with negative FLAG as well as a control group of 10 healthy children. In the diabetic group with negative FLAG as compared to control children the mean resting heart rate was significantly higher, the mean values of cardiovascular reflexes did not show significant differences, however in a third of these patients the narrowing of hyperventilatory arrhythmia was demonstrable. The differences of mean values of all the four investigated parameters in the group with positive FLAG comparing with the control group proved to be significant. According to their results the initial disturbances of the autonomic nervous system in childhood diabetes may appear relatively early--before the preclinical stage of retinal microangiopathy--showing the untimely dysfunction of the parasympathetic nervous system, on the other hand the signs relating to disturbance of the sympathetic nervous system (heart rate ratio on standing/lying, orthostatic blood-pressure decrease) become only in preclinical retinopathic children positive.
作者对15名FLAG阴性的I型糖尿病儿童以及10名健康儿童组成的对照组进行了自主神经病变的临床前体征（静息心率、过度通气性心律失常、站立/卧位心率、直立性血压下降）调查。与对照儿童相比，FLAG阴性的糖尿病组静息心率均值显著更高，心血管反射均值未显示出显著差异，然而在这些患者中有三分之一可证实过度通气性心律失常变窄。FLAG阳性组与对照组相比，所有四个研究参数的均值差异均具有显著性。根据他们的结果，儿童糖尿病自主神经系统的初始紊乱可能相对较早出现——在视网膜微血管病变临床前期之前——表现为副交感神经系统功能过早失调，另一方面，与交感神经系统紊乱相关的体征（站立/卧位心率比、直立性血压下降）仅在临床前视网膜病变儿童中呈阳性。
