Sundkvist G
Diabetes Care. 1981 Sep-Oct;4(5):529-34. doi: 10.2337/diacare.4.5.529.
Fifty-two long-term diabetic patients without symptoms of autonomic neuropathy and 31 age-matched healthy controls were tested for autonomic neuropathy by deep breathing, Valsalva maneuver, and an orthostatic test on tilt table. The deep breathing and the orthostatic tests showed significant parasympathetic impairments in patients with signs of peripheral neuropathy. The Valsalva maneuver, which also mainly reflects parasympathetic function, was disturbed in patients with peripheral neuropathy, but only in those with a very long duration of diabetes. Parasympathetic neuropathy was closely correlated with peripheral neuropathy. However, five patients showed signs of parasympathetic neuropathy but not of peripheral neuropathy. Thus, parasympathetic neuropathy can appear before peripheral neuropathy. On the contrary, sympathetic denervation, as shown from the blood pressure reaction to tilting, only appeared in patients with peripheral neuropathy.
对52名无自主神经病变症状的长期糖尿病患者和31名年龄匹配的健康对照者进行了深呼吸、瓦尔萨尔瓦动作及倾斜试验台上的直立试验，以检测自主神经病变。深呼吸和直立试验显示，有周围神经病变体征的患者存在明显的副交感神经功能损害。主要反映副交感神经功能的瓦尔萨尔瓦动作在周围神经病变患者中受到干扰，但仅见于糖尿病病程很长的患者。副交感神经病变与周围神经病变密切相关。然而，有5名患者表现出副交感神经病变体征，但无周围神经病变体征。因此，副交感神经病变可先于周围神经病变出现。相反，从倾斜试验时的血压反应来看，交感神经去神经支配仅出现在周围神经病变患者中。
