뇌졸중 환자에서 자율신경계 기능의 주관적 및 객관적 평가

Abstract

Objective: To evaluate autonomic function in stroke patients and to explore the relationship between patient's subjective symptoms and the results of objective tests regarding autonomic dysfunction. Method: Twenty stroke patients and 27 controls were recruited. Autonomic function was accessed by subjective checklist and by objective tests such as sympathetic skin response (SSR) and blood pressure (BP) response to positional change and to sustained hand-grip. Motor function was classified using the Brunnstrom stages: Group 1, stage 1 and 2; Group 2, stage 3 and 4; Group 3, stage 5 and 6. Results: Seventy percent of patients had subjective changes in autonomic function after stroke. 50% and 65.5% of patients revealed autonomic insufficiency by BP response tests and SSR, respectively. More than half of the patients who didn't have any subjective changes in autonomic function revealed autonomic insufficiency by objective tests. Group 1 of Brunnstrom stage in upper extremity showed significantly longer SSR latencies (p＜0.05) and lower amplitudes than the controls (p＜0.05). Group 1 and 2 of Brunnstrom stage in lower extremity showed significantly longer SSR latencies (p＜0.05) and lower amplitudes than the controls (p＜0.05). Conclusion: Although stroke patients don't complain any subjective symptoms of autonomic dysfunction, they need to undergo objective autonomic function evaluations such as SSR and BP responses.