Zhou G C, Yu J, Tang H H, Shi J
Department of Spine and Spinal Cord Surgery, China Rehabilitation Research Centre, Beijing, China.
Spinal Cord. 1997 Jun;35(6):390-3. doi: 10.1038/sj.sc.3100421.
Urinary bladder percussion induced autonomic dysreflexia (AD) was observed in spinal cord injured patients with a complete neurological lesion, the upper level being above T5. To document the pathology and study the etiology of autonomic dysreflexia to further investigate its mechanism, this paper presents some clinical data on the determination of vasoactive substances such as norepinephrine (NE), epinephrine (E), renin (R), angiotensin II (AII) and atrial natriuretic polypeptide (ANP) before and during bladder percussion in 30 patients with a thoracolumbar or cervical spine and spinal cord injury. It is demonstrated that tapping the urinary bladder of such patients can cause AD. Changes of some of the vasoactive substances in the plasma were also observed, which might indicate that autonomic dysreflexia result from excitation of the sympathetic nervous system. Overactivity of the sympathetic nervous system was antagonized by excitation of the vegetative nerve system. There was no correlation between changes of blood pressure and adrenal function as well as the change of R-A II system; during autonomic dysreflexia, the inclement of ANP secretion played an important role in recovering homeostasis.
在神经完全损伤且损伤平面在T5以上的脊髓损伤患者中观察到膀胱叩击诱发的自主神经反射异常（AD）。为记录自主神经反射异常的病理并研究其病因以进一步探究其机制，本文给出了30例胸腰椎或颈椎脊髓损伤患者在膀胱叩击前后去甲肾上腺素（NE）、肾上腺素（E）、肾素（R）、血管紧张素II（AII）和心钠素（ANP）等血管活性物质测定的一些临床数据。结果表明，叩击此类患者的膀胱可引发自主神经反射异常。还观察到血浆中一些血管活性物质的变化，这可能表明自主神经反射异常是由交感神经系统兴奋所致。交感神经系统的过度活动被自主神经系统的兴奋所拮抗。血压变化与肾上腺功能以及肾素-血管紧张素II系统的变化之间无相关性；在自主神经反射异常期间，心钠素分泌的增加在恢复体内平衡中起重要作用。
