Ravits J M
Neurology Section, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
Muscle Nerve. 1997 Aug;20(8):919-37. doi: 10.1002/(sici)1097-4598(199708)20:8<919::aid-mus1>3.0.co;2-9.
The autonomic nervous system maintains internal homeostasis by regulating cardiovascular, thermoregulatory, gastrointestinal, genitourinary, exocrine, and pupillary function. Testing and quantifying autonomic nervous system function is an important but difficult area of clinical neurophysiology. Tests of parasympathetic cardiovagal regulation include heart rate analysis during standing (the 30:15 ratio), heart rate variation with deep breathing, and the Valsalva ratio. Tests of sympathetic adrenergic vascular regulation include blood pressure analysis while standing, the Valsalva maneuver, sustained handgrip, mental stress, and cold water immersion. Tests of sympathetic cholinergic sudomotor function include the sympathetic skin response, quantitative sudomotor axon reflex test, sweat box testing, and quantification of sweat imprints. Pupil function is tested pharmacologically and with pupiilographic techniques. Tests of gastrointestinal and genitourinary function do not satisfactorily isolate autonomic regulation from their other functions. The available tests have various sensitivities and ease of administration. They are typically administered in a battery of multiple tests, which improves sensitivity and reliability, and allows probing of various autonomic functions.
自主神经系统通过调节心血管、体温调节、胃肠道、泌尿生殖、外分泌和瞳孔功能来维持体内稳态。测试和量化自主神经系统功能是临床神经生理学中一个重要但困难的领域。副交感神经心脏迷走神经调节的测试包括站立时的心率分析（30:15比率）、深呼吸时的心率变化以及瓦尔萨尔瓦比率。交感神经肾上腺素能血管调节的测试包括站立时的血压分析、瓦尔萨尔瓦动作、持续握力、精神压力和冷水浸泡。交感神经胆碱能汗腺运动功能的测试包括交感神经皮肤反应、定量汗腺运动轴突反射测试、汗盒测试和汗印量化。瞳孔功能通过药理学和瞳孔描记技术进行测试。胃肠道和泌尿生殖功能的测试不能令人满意地将自主调节与其其他功能区分开来。现有的测试具有不同的敏感性和操作简便性。它们通常以一系列多项测试的方式进行，这提高了敏感性和可靠性，并允许对各种自主功能进行探究。
