Hörtnagl H, Brücke T, Hackl J M
Klin Wochenschr. 1979 Apr 17;57(8):391-5. doi: 10.1007/BF01480477.
In severe cases of tetanus an overactivity of the sympathetic nervous system has been postulated because of the clinical symptoms including hypertension, fluctuating blood pressure, tachycardia, tachyarrhythmia and peripheral vasoconstriction. In the present study the involvement of the sympathetic nervous system in tetanus was investigated by serial determinations of plasma adrenaline (A) and noradrenaline (NA) in 2 patients who developed severe symptoms of tetanus and the characteristic cardiovascular disturbances. Sustained high circulating levels of NA and A could be observed indicating a prolonged overactivity of the sympathetic nervous system. In one case, the elevation of the NA level in plasma persisted until the disturbances of the motor nervous system ceased. In a third case of tetanus without cardiovascular abnormalities, the plasma NA and A only increased slightly on a few occasions. The results demonstrate that an overactivity of the sympathetic nervous system can complicate the course of severe tetanus.
在破伤风重症病例中，由于临床症状包括高血压、血压波动、心动过速、快速性心律失常和外周血管收缩，推测存在交感神经系统过度活跃。在本研究中，通过对2例出现严重破伤风症状和典型心血管紊乱的患者连续测定血浆肾上腺素（A）和去甲肾上腺素（NA），来研究交感神经系统在破伤风发病中的作用。可观察到NA和A的循环水平持续处于高位，表明交感神经系统长期过度活跃。在1例患者中，血浆NA水平的升高一直持续到运动神经系统紊乱停止。在第3例无心血管异常的破伤风患者中，血浆NA和A仅在少数情况下略有升高。结果表明，交感神经系统过度活跃会使重症破伤风的病程复杂化。
