单纯自主神经功能衰竭和多系统萎缩的两组慢性自主神经功能衰竭患者在头高位倾斜时血压突增的差异  

Differences in overshoot of blood pressure after headup tilt in two groups with chronic autonomic failure: Pure autonomic failure and multiple system atrophy

作　　者：Asahina M. Young T.M. Bleasdale- Barr K. Mathias C.J. 陈云春 

机构地区：[1]Department of Neurology, Chiba University, Graduate School of Medicine, 1- 8- 1 Inohana, Chuo- ku, Chiba- shi, Chiba 260- 8670, Japan Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第6期36-36,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：On head down tilt to the supine horizontal position (tilt reversal) after head up tilt (HUT), patients with orthostatic hypotension may show an increase in blood pressure (BP)- relative to baseline readings. We assessed this BP overshoot in 8 patients with pure autonomic failure (PAF,64 ± 13 years)- and 8 patients with multiple system atrophy (MSA, 66 ± 10 years). BP was intermittently measured during pre- tilt supine, HUT (60° , 10 min), and post- tilt supine periods. In addition, beat- to- beat BP was measured continuously using the Portapres model 2 device to calculate stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR). There was systolic BP overshoot of ≥ 15 mmHg after tilt reversal in 5 out of 8 PAF, but in only one of 8 MSA. A mean increase of systolic BP in PAF was significantly higher than that in MSA (p < 0.01). TPR increased over baseline level after tilt reversal, although there was no significant difference. SV and CO levels during the post- tilt supine period were similar to baseline levels. In conclusion, BP overshoot was prominent in the PAF group but not in the MSA group. The phenomenon of BP overshoot while supine, especially in PAF, may have implications for long term cardiac and vascular damage in such patients.On head down tilt to the supine horizontal position (tilt reversal) after head up tilt (HUT), patients with orthostatic hypotension may show an increase in blood pressure (BP)- relative to baseline readings. We assessed this BP overshoot in 8 patients with pure autonomic failure (PAF,64 ± 13 years)- and 8 patients with multiple system atrophy (MSA, 66 ± 10 years). BP was intermittently measured during pre- tilt supine, HUT (60° , 10 min), and post- tilt supine periods. In addition, beat- to- beat BP was measured continuously using the Portapres model 2 device to calculate stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR). There was systolic BP overshoot of ≥ 15 mmHg after tilt reversal in 5 out of 8 PAF, but in only one of 8 MSA. A mean increase of systolic BP in PAF was significantly higher than that in MSA (p < 0.01). TPR increased over baseline level after tilt reversal, although there was no significant difference. SV and CO levels during the post- tilt supine period were similar to baseline levels. In conclusion, BP overshoot was prominent in the PAF group but not in the MSA group. The phenomenon of BP overshoot while supine, especially in PAF, may have implications for long term cardiac and vascular damage in such patients.

关 键 词：多系统萎缩 头高位倾斜 突增 头低位倾斜 基线值 外周阻力 心输出量 心搏出量 水平位置 心血管损害 

分 类 号：R741[医药卫生—神经病学与精神病学]