Wang S J, Fuh J L, Shan D E, Liao K K, Lin K P, Tsai C P, Wu Z A
Neurological Institute, Veterans General Hospital-Taipei, Taiwan, ROC.
Mov Disord. 1993 Apr;8(2):151-7. doi: 10.1002/mds.870080206.
We investigated autonomic function in patients with idiopathic Parkinson's disease (PD) by measuring sympathetic skin response (SSR) and R-R interval variation (RRIV). Sixty-two PD patients and 62 age-matched normal subjects were recruited. Abnormal SSR was noted in nine (14.5%) PD patients, including three in Stage II, three in Stage III, and three in Stage IV, but not in Stage I patients or normal subjects. Four of these nine patients had postural hypotension. Abnormal SSR was correlated with duration of illness and impotence. In PD patients, abnormal SSR may be due to intermediolateral column dysfunction. After logarithmic transformation and age adjustment, 19 (31.6%) of 60 PD patients had abnormal RRIV during rest and deep breathing. Abnormal RRIV was not related to staging or duration of illness. Patients with constipation had significantly lower RRIV, indicating parasympathetic dysfunction. RRIV was not affected by acute or chronic L-dopa treatment. The agreement between RRIV and SSR in PD patients was poor (kappa = -0.07). It appears that abnormal SSR, but not RRIV, may be associated with more autonomic disturbances in PD patients.
我们通过测量交感皮肤反应（SSR）和R-R间期变异性（RRIV）来研究特发性帕金森病（PD）患者的自主神经功能。招募了62例PD患者和62例年龄匹配的正常受试者。9例（14.5%）PD患者出现SSR异常，其中II期3例，III期3例，IV期3例，I期患者及正常受试者未出现。这9例患者中有4例出现体位性低血压。SSR异常与病程及阳痿相关。在PD患者中，SSR异常可能归因于中间外侧柱功能障碍。经对数转换和年龄校正后，60例PD患者中有19例（31.6%）在静息和深呼吸时RRIV异常。RRIV异常与分期及病程无关。便秘患者的RRIV显著降低，提示副交感神经功能障碍。RRIV不受急性或慢性左旋多巴治疗的影响。PD患者中RRIV与SSR之间的一致性较差（kappa=-0.07）。看来，SSR异常而非RRIV异常可能与PD患者更多的自主神经功能紊乱有关。
