Wheeler T, Watkins P J
Br Med J. 1973 Dec 8;4(5892):584-6. doi: 10.1136/bmj.4.5892.584.
Evidence for vagal denervation of the heart as a feature of diabetic autonomic neuropathy has been obtained by monitoring beat-to-beat variation in heart rate. Nine diabetics with autonomic neuropathy were assessed; each showed a marked reduction or absence of beat-to-beat variation in comparison with controls. Beat-to-beat variation in normal subjects is abolished by parasympathetic blockade but unaffected by sympathetic blockade. These findings suggest that spontaneous vagal denervation of the heart was present in the cases studied. Measurement of beat-to-beat variation provides a simple test whereby cases of autonomic neuropathy can be screened for cardiac involvement.
通过监测心率逐搏变化，已获得证据表明心脏迷走神经去神经支配是糖尿病自主神经病变的一个特征。对9例患有自主神经病变的糖尿病患者进行了评估；与对照组相比，每例患者的逐搏变化均显著降低或消失。正常受试者的逐搏变化在副交感神经阻滞时消失，但不受交感神经阻滞的影响。这些发现表明，在所研究的病例中存在心脏自发性迷走神经去神经支配。测量逐搏变化提供了一种简单的检测方法，借此可筛查自主神经病变患者是否存在心脏受累情况。
