Jha S, Nag D
Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
Indian J Physiol Pharmacol. 1995 Apr;39(2):149-53.
Study was conducted on 34 middle aged (35-52 years) diabetics of either sex to compare autonomic function in patients having and not having symptoms of dysautonomia. Fifteen age/sex matched healthy non-diabetic volunteers were control. No symptom of autonomic insufficiency was present in 19 (55.8%) while 15 (43%) diabetics had dysfunction in form of episodic syncope, vertigo, and palpitation, all on postural change. Tests of autonomic functions were restricted to evaluation of salivation, lacrimation, sweating, pilomotor response, reflex erythema and blood pressure changes with valsalva, posture and cold pressor. SSR was elicited using 5 stimuli on programmed Neuropack II and IV model machine. In asymptomatic diabetics, tests of autonomic functions were normal and comparable to controls but SSR was not recordable in 8 (42%). In remaining 11 (58%) asymptomatic diabetics, it was recordable. In 15 subjects who had symptoms of autonomic dysfunction, 6 (40%) had positive test of autonomic function but SSR was normal in only 5 (34%) and not recordable in 10 (66%) subjects. We conclude that SSR can be used as a easy, sensitive and probably early indicator of autonomic functions.
对34名年龄在35至52岁之间的中年糖尿病患者（男女不限）进行了研究，以比较有自主神经功能障碍症状和无自主神经功能障碍症状患者的自主神经功能。15名年龄/性别匹配的健康非糖尿病志愿者作为对照。19名（55.8%）患者无自主神经功能不全症状，而15名（43%）糖尿病患者有发作性晕厥、眩晕和心悸等功能障碍，均在体位改变时出现。自主神经功能测试仅限于评估唾液分泌、泪液分泌、出汗、立毛肌反应、反射性红斑以及valsalva动作、体位和冷加压试验时的血压变化。使用程序化的Neuropack II和IV型机器上的5种刺激来引出交感皮肤反应（SSR）。在无症状的糖尿病患者中，自主神经功能测试正常，与对照组相当，但8名（42%）患者无法记录到SSR。在其余11名（58%）无症状糖尿病患者中，SSR可记录。在15名有自主神经功能障碍症状的患者中，6名（40%）自主神经功能测试呈阳性，但只有5名（34%）患者的SSR正常，10名（66%）患者无法记录到SSR。我们得出结论，SSR可作为一种简单、敏感且可能是自主神经功能的早期指标。
