Panzram G, Tiedt N, Aisch W, Kaiser W D
Dtsch Med Wochenschr. 1983 May 13;108(19):729-34. doi: 10.1055/s-2008-1069630.
Thirty diabetics with peripheral neuropathy underwent complex assessment of autonomic nervous disorders of seven different organ systems. Functional analysis was done of the cardiovascular system (respiratory arrhythmia at rest and during regulated breathing, 3rd order waves of cardiac frequency and of arterial mean pressure, active and passive orthostasis), pupillary regulation (infra-red pupillography), peripheral vasomotor regulation (skin temperature) and sudomotorics (psychogalvanic skin reflex). Involvement of the genitourinary system, of stomach and intestine was evaluated by clinical criteria. Twelve diabetics showed signs of autonomic neuropathy in four to six, eight patients in three organ systems. The amplitudes of respiratory arrhythmia during regulated breathing, spectral analytic evaluation of cardiac frequency waves of 3rd order and cardiac frequency immediate reaction during orthostasis were particularly indicative. The demonstrated disturbance of conduction of centrally generated cardiac frequency waves of 3rd order and the diminished amplitudes of the spontaneous rhythms of acral skin temperatures complement the previously known symptomatology of autonomic diabetic neuropathy. The systemic character of autonomic diabetic neuropathy objectivated by the investigations indicates a metabolic pathogenesis.
30例患有周围神经病变的糖尿病患者接受了对七个不同器官系统自主神经功能紊乱的综合评估。对心血管系统进行了功能分析（静息及规律呼吸时的呼吸性心律失常、心率和动脉平均压的三级波、主动和被动直立位）、瞳孔调节（红外瞳孔描记法）、外周血管舒缩调节（皮肤温度）和泌汗功能（心理皮电反射）。通过临床标准评估泌尿生殖系统、胃和肠道的受累情况。12例糖尿病患者在四至六个器官系统出现自主神经病变体征，8例患者在三个器官系统出现病变体征。规律呼吸时的呼吸性心律失常幅度、三级心率波的频谱分析评估以及直立位时的心率即时反应尤其具有指示性。所证实的中枢产生的三级心率波传导障碍以及手足皮肤温度自发节律幅度减小，补充了先前已知的糖尿病自主神经病变症状学。这些研究证实的糖尿病自主神经病变的系统性特征表明其发病机制为代谢性。
