Singh N K, Jaiswal A K, Misra S, Srivastava P K
Acta Neurol Scand. 1987 Feb;75(2):101-5. doi: 10.1111/j.1600-0404.1987.tb07902.x.
Twenty-four patients with Guillain-Barré syndrome were prospectively evaluated for evidence of autonomic dysfunction. It occurred in 16 (66.7%) patients, usually during the peak period of paralysis, in the form of either excess or inadequate activity of sympathetic and/or parasympathetic nervous systems. Its clinical manifestations comprised of sinus tachycardia (33.3%), bradycardia (8.3%), hypertension (33.3%), postural hypotension (35%), urinary sphincteric disturbances (20.8%) and anhydrosis of lower limbs (12.5%). Assessment of cardiovascular responses to autonomic function tests revealed impaired alterations in heart rate during deep breathing (31.6%), Valsalva's manoeuvre (28.6%), sustained handgrip (25%), cold-pressor test (36.4%), postural change (35%) and atropine test (20%); and impaired rise in blood pressure during firm handgrip (25%) and cold-pressor test (36.6%). ECG abnormalities were noticed in 8 (33.3%) patients. They comprised of depressed ST segment in 5, inverted T wave in 3, tall T wave in 2 and prolonged QTc in 2 patients. Two patients died of respiratory failure. Autonomic dysfunction in Guillain-Barré syndrome did not appear to have any prognostic significance as there was no significant difference in autonomic dysfunction between good - and bad - outcome groups of patients.
对24例吉兰-巴雷综合征患者进行前瞻性评估，以寻找自主神经功能障碍的证据。16例（66.7%）患者出现自主神经功能障碍，通常发生在瘫痪高峰期，表现为交感和/或副交感神经系统活动过度或不足。其临床表现包括窦性心动过速（33.3%）、心动过缓（8.3%）、高血压（33.3%）、体位性低血压（35%）、尿道括约肌功能障碍（20.8%）和下肢无汗（12.5%）。对自主神经功能测试的心血管反应评估显示，深呼吸（31.6%）、瓦尔萨尔瓦动作（28.6%）、持续握力（25%）、冷加压试验（36.4%）、体位改变（35%）和阿托品试验（20%）时心率变化受损；用力握力（25%）和冷加压试验（36.6%）时血压升高受损。8例（33.3%）患者出现心电图异常。包括5例ST段压低、3例T波倒置、2例T波高尖和2例QTc延长。2例患者死于呼吸衰竭。吉兰-巴雷综合征中的自主神经功能障碍似乎没有任何预后意义，因为预后良好和预后不良的患者组之间自主神经功能障碍没有显著差异。
