Gould G A, Ashworth M, Lewis G T
Thorax. 1986 May;41(5):372-5. doi: 10.1136/thx.41.5.372.
Non-invasive tests of cardiovascular autonomic function were performed in 69 patients with histologically proved bronchial carcinoma and the results compared with those obtained in a group of age and sex matched controls. Only two patients were under 50 years of age, and with the exception of the heart rate response to deep breathing the tests performed have no accepted normal ranges in patients of this age. None of the patients had features of florid, disabling autonomic neuropathy. All the tests of autonomic function showed declining performance with age but in addition there were significant differences in the results when the two groups were compared. In the group with carcinoma the resting heart rate was higher (p less than 0.05), the resting supine blood pressure lower (p less than 0.01), and the postural fall in blood pressure greater (p less than 0.01). Test results were not related to tumour histology, the presence of finger clubbing, drug history, or symptoms suggestive of autonomic dysfunction. Abnormal responses in tests of cardiovascular autonomic function are commonly found in elderly patients but bronchial carcinoma appears to have an additional effect. The precise mechanism of this effect remains a matter for speculation.
对69例经组织学证实为支气管癌的患者进行了心血管自主神经功能的无创检测，并将结果与一组年龄和性别匹配的对照组进行了比较。只有两名患者年龄在50岁以下，除了对深呼吸的心率反应外，所进行的检测在这个年龄段的患者中没有公认的正常范围。所有患者均无明显的、致残性自主神经病变特征。所有自主神经功能检测结果均显示随年龄增长而下降，但两组比较时结果仍存在显著差异。癌症组静息心率较高（p<0.05），静息仰卧位血压较低（p<0.01），血压的姿势性下降幅度较大（p<0.01）。检测结果与肿瘤组织学、杵状指的存在、用药史或提示自主神经功能障碍的症状无关。心血管自主神经功能检测中的异常反应在老年患者中很常见，但支气管癌似乎有额外影响。这种影响的确切机制仍有待推测。
