Acute orthostatic hypotension when starting dopamine agonists in Parkinson's disease
Acute orthostatic hypotension when starting dopamine agonists in Parkinson's disease
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DOI：
10.1001/archneur.57.10.1461
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发表时间：
2000-10-01
影响因子：
--
通讯作者：
Goetz, CG
中科院分区：
文献类型：
--
作者：
Kujawa, K;Leurgans, S;Goetz, CG
目的：研究帕金森病患者开始多巴胺受体激动剂therapeutic.Patients和方法的频率和严重程度急性直立性低血压（OH）：在门诊的临床实践的背景下，连续29例帕金森病患者开始多巴胺受体激动剂治疗被带入临床的第一剂量的激动剂。基线仰卧位和站立位血压评估后，给予患者甲磺酸培高利特（0.025、0.05、0.125或0.25 mg）、盐酸普拉克索（0.125 mg）或盐酸罗匹尼罗（0.125或0.25 mg）试验剂量。在3个选定的时间，血压读数重复仰卧和站立position.Main结果Measure：直立性低血压被定义为收缩压下降超过25毫米汞柱或舒张压超过10毫米汞柱。OH的多巴胺受体激动剂给药前的患者被排除在外。结果：10例（34%）符合急性OH的标准。没有证据表明OH与使用特定多巴胺激动剂或同时使用左旋多巴相关。符合OH标准的患者中，只有3（30%）有OH的症状，如头晕目眩或全身不适。结论：急性OH经常发生时，开始多巴胺受体激动剂治疗帕金森病，但往往不赞赏患者。急性血压反应的知识可能是有用的，在临床实践中作出决定激动剂滴定时间表。
Objective: To study the frequency and severity of acute orthostatic hypotension (OH) in patients with Parkinson's disease who are starting dopamine agonist therapy.Patients and Methods: In the context of an outpatient clinical practice, 29 consecutive patients with Parkinson's disease who were starting dopamine agonist therapy were brought into the clinic for their first dose of agonist. After a baseline supine and standing blood pressure assessment, patients were given a test dose of either pergolide mesylate (0.025, 0.05, 0.125, or 0.25 mg), pramipexole dihydrochloride (0.125 mg), or ropinirole hydrochloride (0.125 or 0.25 mg). At 3 selected times, blood pressure readings were repeated in the supine and standing positions.Main Outcome Measure: Orthostatic hypotension was defined as a drop in either systolic blood pressure of more than 25 mm Hg or diastolic pressure of more than 10 mm Hg. Patients with OH before the administration of the dopamine agonist were excluded.Results: Ten subjects (34%) met the criteria for acute OH. There was no evidence that OH was related to the use of a specific dopamine agonist or the concurrent use of levodopa. Of the patients who met the criteria for OH, only 3 (30%) had symptoms of OH, such as lightheadedness or general malaise.Conclusions: Acute OH occurs frequently when starting dopamine agonist therapy in Parkinson's disease, but is frequently not appreciated by patients. Knowledge of acute blood pressure responses may be useful when making decisions regarding agonist titration schedules in clinical practice.