Comi G, Natali Sora M G, Ghilardi M F, Canal N, Galimberti G, Librenti M C, Micossi P, Pozza G
Acta Diabetol Lat. 1986 Oct-Dec;23(4):323-9. doi: 10.1007/BF02582065.
The present study evaluates the reproducibility of five cardiovascular reflex tests, deep breathing (DB), Valsalva maneuver (VM), sustained hand-grip (SHG), postural hypotension (PH) and lying to standing (LS) in normal subjects and in insulin dependent (type I) diabetic patients. The study was carried out in 10 normal subjects, in 10 diabetics with autonomic neuropathy and in 10 diabetics without autonomic neuropathy. The five cardiovascular reflex tests were performed five times on five consecutive days by the same investigator and in identical basal conditions. The intraindividual variability of DB, LS and VM was significantly reduced in diabetics with autonomic neuropathy compared with normal controls, but there was no difference between diabetics without neuropathy and normal controls. The intraindividual variability of PH was significantly increased in diabetics with autonomic neuropathy compared with diabetics without autonomic neuropathy and with normal controls. There was no difference among the three groups in the reproducibility of SHG. In normal subjects the intraindividual variability only exceptionally produced a shift from normal to abnormal values or vice versa; in diabetics with autonomic neuropathy this shift was more frequent.
本研究评估了五项心血管反射测试（深呼吸（DB）、瓦尔萨尔瓦动作（VM）、持续握力（SHG）、体位性低血压（PH）和卧位到立位（LS））在正常受试者以及胰岛素依赖型（I型）糖尿病患者中的可重复性。该研究纳入了10名正常受试者、10名患有自主神经病变的糖尿病患者和10名未患自主神经病变的糖尿病患者。这五项心血管反射测试由同一名研究者在连续五天内、在相同的基础条件下进行了五次。与正常对照组相比，患有自主神经病变的糖尿病患者DB、LS和VM的个体内变异性显著降低，但未患神经病变的糖尿病患者与正常对照组之间无差异。与未患自主神经病变的糖尿病患者及正常对照组相比，患有自主神经病变的糖尿病患者PH的个体内变异性显著增加。三组在SHG的可重复性方面无差异。在正常受试者中，个体内变异性仅偶尔导致从正常到异常值或反之的转变；在患有自主神经病变的糖尿病患者中，这种转变更为频繁。
