Cardiac Autonomic Neuropathy in Diabetes Mellitus.
Cardiac Autonomic Neuropathy in Diabetes Mellitus.
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DOI：
10.14797/mdcj-14-4-251
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发表时间：
2018-10-01
影响因子：
--
通讯作者：
Petak, Steven
中科院分区：
文献类型：
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作者：
Agashe, Shruti;Petak, Steven
心血管自主神经病变（CAN）是糖尿病患者的一种严重衰弱但诊断不足的疾病。 1 型糖尿病患者的患病率从 2.5%（基于糖尿病控制和并发症试验中的一级预防队列）到高达 90% 不等。临床表现范围从直立性停滞到心肌梗死。通过多项自主神经功能测试来评估交感神经和副交感神经功能来做出诊断。 CAN 的病理生理学很复杂，可能是多因素的，而且尚未完全了解。治疗仅限于对体位性低血压进行症状控制，这是一种晚期并发症，目前逆转 CAN 的策略也很有限。本综述探讨了 CAN 的流行病学、病理生理学、临床表现、诊断和并发症以及当前的治疗方案。
Cardiovascular autonomic neuropathy (CAN) is a severely debilitating yet underdiagnosed condition in patients with diabetes. The prevalence can range from 2.5% (based on the primary prevention cohort in the Diabetes Control and Complications Trial) to as high as 90% of patients with type 1 diabetes. Clinical manifestations range from orthostasis to myocardial infarction. The diagnosis is made using multiple autonomic function tests to assess both sympathetic and parasympathetic function. The pathophysiology of CAN is complex, likely multifactorial, and not completely understood. Treatment is limited to symptomatic control of orthostatic hypotension, which is a late complication, and current strategies to reverse CAN are limited. This review explores the epidemiology, pathophysiology, clinical manifestations, diagnosis, and complications of CAN as well as current treatment options.