Kasthuri A S, Yadav Rps
Assoc Prof (Medicine), Armed Forces Medical College, Pune 411040.
Classified Specialist (Medicine), INHS Kasturi, Lonavala.
Med J Armed Forces India. 1997 Jan;53(1):7-10. doi: 10.1016/S0377-1237(17)30635-4. Epub 2017 Jun 26.
Forty-eight out of 95 patients with diabetes mellitus, who were asymptomatic for autonomic nervous system affections, were evaluated with 3 bedside tests to detect subclinical cardiac neuropathy. There were 25 males and 23 females in the age range of 10-60 years. The three tests carried out were, heart rate response to Valsalva manoeuvre, heart rate variation during deep breathing, and systolic blood pressure fall in response to standing. Of these 48 patients, 15 (31.3%) had evidence of neuropathy. Abnormality of the parasympathetic division was found in 13 patients and the remaining 2 patients had borderline affection. Three patients had evidence of a combined parasympathetic and sympathetic involvement. Sympathetic affection alone was not detected in any patient. Increased incidence was seen in older age group. Autonomic neuropathy was more common in patients who had the disease for over 5 years. There was no correlation with the sex of the patient or with metabolic control of diabetes.
95例无症状自主神经系统病变的糖尿病患者中，48例接受了3项床边检查以检测亚临床心脏神经病变。患者年龄在10至60岁之间，其中男性25例，女性23例。所进行的三项检查分别是：瓦尔萨尔瓦动作时的心率反应、深呼吸时的心率变异性以及站立时的收缩压下降。在这48例患者中，15例（31.3%）有神经病变的证据。13例患者发现副交感神经分支异常，其余2例有临界病变。3例患者有副交感神经和交感神经联合受累的证据。未在任何患者中检测到单独的交感神经受累。老年组发病率增加。自主神经病变在患病超过5年的患者中更为常见。与患者性别或糖尿病的代谢控制无关。
