Clinical Analysis Of Autonomic Dysfunction In Multiple System Atrophy

Objective:1.To explore the characteristics and severity of autonomic dysfunction in patients with MSA by analysing post-void residual volume and decline in blood pressure between possible MSA and probable MSA.Furthermore,to compare them between two subtypes of MSA.2.To explore the characteristics of cardiovascular autonomic dysfunction in patients with multiple system atrophy by analyzing heart rate variability.Methods:1.According to the criteria of MSA classification,46 patients with multiple system atrophy were divided into probable MSA group(n=27)and possible MSA group(n=19).Probable MSA group(range from 43 to 77)were further divided into MSA-P subtype(n=10)and MSA-C subtype(n=17).Possible MSA group(range from 49 to76)were further divided into MSA-P subtype(n=10)and MSA-C subtype(n=17).The clinical data of all the patients were collected,including sex,age,first onset symptoms,course of disease,signs and past medical history.All patients completed post-void residual volume,supine orthostatic blood pressure examination.2.From January 2017 to December 2017,15 patients(56 to 78 years)with multiple system atrophy,from our hospital were enrolled in our hospital.13 healthy subjects(54~76 years old)were selected at the same time.All subjects were examined by dynamic electrocardiogram(ECG)to analyze the cardiac autonomic nerve damage in patients with MSA.Results:1.1)There was no significant difference in clinical symptoms about autonomic dysfunction between MSA-P type and MSA-C type(P>0.05);2)There was no significant difference between the two subtypes of The positive rate of bladder residual urine and post-void residual volume(P>0.05);3)The positive rate of orthostatic hypotension between the two subtypes of MSA was similar.Further analysis of the decline of systolic and diastolic blood pressure in patients with positive supine orthostatic blood pressure showed that there was no significant difference between two types of MSA;4)There was no significant difference in bladder residual urine volume between probable MSA and possible MSA patients(P>0.05);5)The positive rate of orthostatic hypotension in probable MSA patients was significantly higher than that in possible MSA(P<0.05).2.SDNN Index?LF and HF in MSA patients was significantly lower than that in healthy controls(P < 0.05).Conclusion:(1)The incidence and severity of urinary dysfunction were similar between the two subtypes of MSA.(2)The incidence and severity of cardiovascular autonomic dysfunction were similar between the two subtypes of MSA.(3)Heart rate variability can be used to evaluate cardiac sympathetic and parasympathetic nervous impairment in patients with MSA.