Goldstein I B, Naliboff B D, Shapiro D, Frank H J
Department of Psychiatry, UCLA 90024-1759.
Diabetes Care. 1988 Nov-Dec;11(10):774-9. doi: 10.2337/diacare.11.10.774.
Nine insulin-dependent diabetic (IDDM) patients (aged 25-37 yr) with no symptoms of autonomic neuropathy and 15 healthy control subjects (aged 26-39 yr) were studied at rest and during tests of Valsalva maneuver, deep breathing, cold pressor, and postural change from sitting to standing. Continuous (beat-to-beat) measures were taken of heart rate, systolic blood pressure, diastolic blood pressure, and skin conductance. The diabetic patients were differentiated from the control group by the following: less variability in diastolic blood pressure during deep breathing, failure to exhibit diastolic blood pressure decreases during recovery from a cold pressor stimulus, a flatter blood pressure response pattern when changing from sitting to standing, and a smaller standing ratio (maximum/minimum) for R-R interval. Among the patients, age was negatively correlated with systolic and diastolic standing ratios and diastolic blood pressure variability during deep breathing. By use of the tracking cuff, a method of continuously recording blood pressure noninvasively, we have been able to assess subtle blood pressure changes, thereby revealing signs of sympathetic dysfunction in a group of relatively young diabetic patients with no symptoms of neuropathy. The tracking-cuff method of recording blood pressure has potential in further research on autonomic functioning in diabetic patients.
对9名无自主神经病变症状的胰岛素依赖型糖尿病（IDDM）患者（年龄25 - 37岁）和15名健康对照者（年龄26 - 39岁）在静息状态以及进行瓦尔萨尔瓦动作、深呼吸、冷加压和从坐位到站立位姿势改变测试期间进行了研究。连续（逐搏）测量心率、收缩压、舒张压和皮肤电导。糖尿病患者与对照组的区别如下：深呼吸时舒张压变异性较小、冷加压刺激恢复过程中舒张压未出现下降、从坐位到站立位时血压反应模式较平坦以及R-R间期的站立比值（最大值/最小值）较小。在患者中，年龄与收缩压和舒张压站立比值以及深呼吸时的舒张压变异性呈负相关。通过使用追踪袖带这种无创连续记录血压的方法，我们得以评估细微的血压变化，从而在一组无神经病变症状的相对年轻糖尿病患者中发现交感神经功能障碍的迹象。追踪袖带记录血压的方法在糖尿病患者自主神经功能的进一步研究中具有潜力。
