COMPOSITE AUTONOMIC SCORING SCALE FOR LABORATORY QUANTIFICATION OF GENERALIZED AUTONOMIC FAILURE
COMPOSITE AUTONOMIC SCORING SCALE FOR LABORATORY QUANTIFICATION OF GENERALIZED AUTONOMIC FAILURE
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DOI：
10.1016/s0025-6196(12)60631-4
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发表时间：
1993-08-01
影响因子：
8.9
通讯作者：
LOW, PA
中科院分区：
文献类型：
--
作者：
LOW, PA
自主反射筛查包括定量催汗轴突反射测试、直立血压和对倾斜的心率反应、对深呼吸的心率反应、瓦尔萨尔瓦比率以及瓦尔萨尔瓦动作第二阶段和第四阶段、倾斜和深呼吸期间的逐次血压测量，用于开发自主神经功能的 10 点复合自主评分量表。该方案为肾上腺素能障碍分配 4 分，为催汗和心迷走神经衰竭各分配 3 分。每个分数都根据年龄和性别的复合影响进行标准化。综合自主神经评分量表得分为3分或以下的患者仅患有轻度自主神经衰竭，得分为7至10分的患者患有严重自主神经衰竭，得分在这两个范围之间的患者患有中度自主神经衰竭。通过评估四组已知自主神经功能衰竭程度的患者的综合自主神经评分量表来评估该方法的敏感性和特异性：18 名患有多系统萎缩的患者，20 名患有自主神经病变的患者，20 名患有帕金森病的患者，20 名患有周围神经病变但无自主神经症状的患者。这四组的综合评分（平均值+/-标准差）分别如下：8.5 +/- 1.3、8.6 +/- 1.2、1.5 +/- 1.1 和 1.7 +/- 1.3。有症状的自主神经衰竭患者的评分为 5 分或以上，无症状的自主神经衰竭患者的评分为 4 分或以下，并且这些组中不存在重叠。因此，自主神经实验室测试应该有助于对自主神经衰竭的程度进行分级。
An autonomic reflex screen, which consisted of a quantitative sudomotor axon reflex test, orthostatic blood pressure and heart rate response to tilt, heart rate response to deep breathing, the Valsalva ratio, and beat-to-beat blood pressure measurements during phases II and IV of the Valsalva maneuver, tilt, and deep breathing, was used to develop a 10-point composite autonomic scoring scale of autonomic function. The scheme allots 4 points for adrenergic and 3 points each for sudomotor and cardiovagal failure. Each score is normalized for the compounding effects of age and sex. Patients with a score of 3 or less on the composite autonomic scoring scale have only mild autonomic failure, those with scores of 7 to 10 have severe failure, and those with scores between these two ranges have moderate autonomic failure. The sensitivity and specificity of the method were assessed by evaluating the composite autonomic scoring scale in four groups of patients with known degrees of autonomic failure: 18 with multisystem atrophy, 20 with autonomic neuropathy, 20 with Parkinson's disease, and 20 with peripheral neuropathy but no autonomic symptoms. The composite scores (means +/- SD) for these four groups, respectively, were as follows: 8.5 +/- 1.3, 8.6 +/- 1.2, 1.5 +/- 1.1, and 1.7 +/- 1.3. Patients with symptomatic autonomic failure had scores of 5 or more, those without symptomatic autonomic failure had scores of 4 or less, and no overlap existed in these groups. Thus, autonomic laboratory tests should be useful in grading the degree of autonomic failure.