Faes T J, Wagemans M F, Cillekens J M, Scheffer G J, Karemaker J M, Bertelsmann F W
Laboratory of Medical Physics, Free University Hospital, Amsterdam, The Netherlands.
Clin Auton Res. 1993 Oct;3(5):319-24. doi: 10.1007/BF01827333.
Skin sympathetic vasomotor control can be examined in the extremities by the skin vasomotor test. In this test the change in skin blood flow and skin temperature in the hand and foot in response to a cold stimulus is utilized as an index of distal sympathetic nerve fibre integrity. This is of importance in conditions such as diabetes mellitus as peripheral autonomic neuropathy is associated with orthostatic hypotension and diabetic foot complications. The validity and reproducibility of the test as a marker of distal sympathetic nerve function has been studied. The test was performed in nine healthy control subjects and in nine subjects (undergoing minor surgery) after a sympathetic nerve conduction block (L2-L3) was achieved in the lower extremities by spinal analgesia. Changes in skin temperature (p < 0.001) and skin blood flow (p < 0.005) in responses to cooling were significantly larger in the control group than in the group with spinal analgesia. Repeated skin temperature measurements on 42 occasions (test-retest period of 4 weeks) in eight healthy and 34 diabetic subjects indicated a reliability coefficient of 80%. We conclude, therefore, that the skin vasomotor test provides a valid and reproducible quantitative assessment of skin sympathetic nerve function in upper and lower extremities.
皮肤交感神经血管运动控制可通过皮肤血管运动试验在四肢进行检查。在该试验中，手部和足部皮肤血流及皮肤温度对冷刺激的变化被用作远端交感神经纤维完整性的指标。这在糖尿病等病症中很重要，因为外周自主神经病变与体位性低血压和糖尿病足并发症相关。该试验作为远端交感神经功能标志物的有效性和可重复性已得到研究。在9名健康对照受试者以及9名（接受小手术的）受试者中进行了该试验，这些受试者通过脊髓镇痛在下肢实现了交感神经传导阻滞（L2 - L3）。对照组对冷却的反应中，皮肤温度变化（p < 0.001）和皮肤血流变化（p < 0.005）显著大于脊髓镇痛组。对8名健康受试者和34名糖尿病受试者进行了42次重复皮肤温度测量（重测间隔为4周），结果显示可靠性系数为80%。因此，我们得出结论，皮肤血管运动试验为上下肢皮肤交感神经功能提供了有效且可重复的定量评估。
