Senaratne M P, Carroll D, Warren K G, Kappagoda T
J Neurol Neurosurg Psychiatry. 1984 Sep;47(9):947-52. doi: 10.1136/jnnp.47.9.947.
In 21 patients with multiple sclerosis and 20 healthy controls, the following tests of autonomic function were examined: (1) variation in heart rate during deep breathing, (2) the variations in heart rate and systolic blood pressure during a standardised Valsalva manoeuvre, (3) the changes in heart rate and systolic blood pressure during arm ergometry starting at 30 W with increments of 20 W every 3 min. In the control subjects the maximum variation in heart rate from inspiration to expiration was greater than 16 beat/min (range 17-43). In patients with multiple sclerosis, five had a maximum variation in heart rate of less than 13 beat/min which was considered as the lower limit of normal. The Valsalva ratio in the control subjects ranged from 1.33-3.24. Four patients had Valsalva ratios of less than 1.30. In patients with multiple sclerosis the heart rate and systolic blood pressure responses to exercise were attenuated significantly in four and seven subjects respectively. It is concluded that a significant number of patients with multiple sclerosis show evidence of autonomic dysfunction involving the cardiovascular system.
对21例多发性硬化症患者和20名健康对照者进行了以下自主神经功能测试：(1)深呼吸时心率变化；(2)标准化瓦尔萨尔瓦动作时心率和收缩压变化；(3)手臂测力计运动时心率和收缩压变化，起始功率为30W，每3分钟增加20W。在对照受试者中，吸气到呼气时心率的最大变化大于16次/分钟(范围为17 - 43)。在多发性硬化症患者中，有5例心率最大变化小于13次/分钟，这被认为是正常下限。对照受试者的瓦尔萨尔瓦比率在1.33 - 3.24之间。4例患者的瓦尔萨尔瓦比率小于1.30。在多发性硬化症患者中，分别有4例和7例受试者运动时心率和收缩压反应明显减弱。结论是，大量多发性硬化症患者存在涉及心血管系统的自主神经功能障碍证据。
