站立后即刻心率反应：糖尿病自主神经病变的简易检测方法
Immediate heart-rate response to standing: simple test for autonomic neuropathy in diabetes.
作者信息
Ewing D J, Campbell I W, Murray A, Neilson J M, Clarke B F
出版信息
Br Med J. 1978 Jan 21;1(6106):145-7. doi: 10.1136/bmj.1.6106.145.
Abstract
The immediate heart-rate response to standing was measured in 22 normal controls and 25 patients with diabetes, 15 of whom had autonomic neuropathy. The response in the controls and patients without autonomic neuropathy was characteristic and consistent, with tachycardia maximal at around the 15th beat and relative bradycardia maximal at around the 30th beat. The diabetics with autonomic neuropathy, however, showed a flat response. In three controls the response was abolished with intravenous atropine but not with propranolol, showing that it is mediated through the vagus. A simplified test using routine ECGs and measuring the R-R interval at beats 15 and 30 with a ruler is easily performed as an outpatient procedure and may be used as a measure of autonomic function in diabetes.
摘要
对22名正常对照者和25名糖尿病患者测量了站立后即刻的心率反应，其中15名糖尿病患者患有自主神经病变。正常对照者和无自主神经病变的患者的反应具有特征性且一致，心动过速在第15次搏动左右达到最大值，相对心动过缓在第30次搏动左右达到最大值。然而，患有自主神经病变的糖尿病患者表现出无反应。在3名对照者中，静脉注射阿托品可消除该反应，但普萘洛尔不能，这表明该反应是通过迷走神经介导的。使用常规心电图并通过直尺测量第15次和第30次搏动时的R-R间期的简化测试作为门诊程序很容易进行，并且可用于衡量糖尿病患者的自主神经功能。
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