老年慢性脑供血不足患者交感皮肤反应临床研究

Clinical study on sympathetic skin response in elderly patients with chronic cerebral circulation insufficiency

目的评价老年慢性脑供血不足(CCCI)患者交感皮肤反应(SSR)变化,探讨其自主神经(ANS)功能状态。方法采用M-314636型肌电诱发电位仪分组检测51例前循环CCCI患者和42例后循环CCCI患者的SSR,并以86例健康老年人为对照进行比较。结果患者SSR波引出率上肢77.4%,下肢71.0%,均显著低于对照组(P<0.01);SSR波潜伏期前循环CCCI上肢(1.42±0.19)ms,下肢(1.83±0.36)ms,与对照组比较差异无统计学意义(P>0.05),后循环CCCI上肢(1.73±0.31)ms,下肢(1.96±0.33)ms,较对照组、前循环CCCI显著延长(P<0.01);患者SSR波波幅上肢(2.42±0.33)mV,下肢(1.47±0.32)mV,较对照组明显降低(P<0.05),后循环CCCI下肢波幅降低更突出,为(1.38±0.41)mV,显著低于前循环CCCI(P<0.05)。结论老年CCCI患者存在ANS功能异常,后循环CCCI重于前循环CCCI,这种异常可能与ANS中枢的持续性累积损伤有关。

Objective To evaluate changes of sympathetic skin response（SSR） in the elderly patients with chronic cerebral circulation insufficiency（CCCI）,and investigate their autonomic function.Methods SSR of 51 patients with procyclic CCCI and 42 patients with metacyclic CCCI were tested in groups with M-314636 motor evoked potential instrument,and 86 healthy elders served as control group.Results The occurrence of SSR in patients was 77.4% of arms and 71.0% of legs separately,both lower than that in controls significantly（P0.01）.SSR latency of arms and legs in procyclic CCCI was（1.42±0.19） ms and（1.83±0.36） ms respectively,which did not show any significant changes compared with that in controls（P0.05）.Latency of arms and legs in metacyclic CCCI was（1.73±0.31） ms and（1.96±0.33） ms respectively,longer than that in controls and procyclic CCCI markedly（P0.01）.SSR amplitude of arms and legs in patients was（2.42±0.33） mV and（1.47±0.32） mV respectively,lower than that in controls distinctly（P0.05）.With much more drop amplitude of legs in metacyclic CCCI was（1.38±0.41） mV,lower than that in procyclic CCCI significantly（P0.05）.Conclusion There exists dysfunction of autonomic nervous system（ANS） in elderly patients with CCCI,more serious in metacyclic CCCI than in procyclic CCCI.The kind of dysfunction may have something to do with continuous accumulative damage suffered by ANS center.