Solders G, Persson A, Wilczek H
Transplantation. 1986 May;41(5):616-9. doi: 10.1097/00007890-198605000-00013.
Polyneuropathy and autonomic dysfunction were studied in 15 patients with nondiabetic terminal uremia before renal transplantation and again at 6 and 12 months after the transplantation. Beat-to-beat variation of the electrocardiogram (ECG) relative to mean beat interval was used as an observation of the function of the parasympathetic vagal reflex arc. Marked autonomic dysfunction--i.e., reduced beat-to-beat variation and a mild diffuse polyneuropathy--was found. The neuropathy was mainly of axonal type, but a slowing of conduction velocities was also found. The latter was markedly improved after transplantation and is suggested to be caused by a toxic metabolic factor, possibly causing nodal dysfunction. Action potential amplitudes and autonomic function did not improve during the study. This implies a structural damage that is not repaired in 12 months. Neurological examination should be included in the care of patients with uremia, and the results should be one of the factors considered when transplantation is discussed.
对15例非糖尿病终末期尿毒症患者在肾移植前、移植后6个月和12个月时进行了多发性神经病和自主神经功能障碍的研究。心电图（ECG）逐搏变化相对于平均搏动间期被用作副交感迷走反射弧功能的观察指标。发现存在明显的自主神经功能障碍，即逐搏变化减少和轻度弥漫性多发性神经病。神经病变主要为轴索性，但也发现传导速度减慢。后者在移植后明显改善，提示由毒性代谢因素引起，可能导致结功能障碍。在研究期间，动作电位幅度和自主神经功能未改善。这意味着存在一种在12个月内未修复的结构性损伤。尿毒症患者的护理应包括神经学检查，其结果应是讨论移植时考虑的因素之一。
