The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia.
The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia.
复制标题
DOI：
10.1371/journal.pone.0045451
复制
发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Londos E
中科院分区：
文献类型：
--
作者：
Stubendorff K;Aarsland D;Minthon L;Londos E
自主神经功能障碍是神经退行性痴呆的一个众所周知的特征，尤其常见于α-突触核蛋白病，如路易体痴呆和帕金森病痴呆。最常见的症状是体位性低血压、尿失禁和便秘，但其在临床实践中的相关性知之甚少。目前还没有早期的研究探讨自主神经功能障碍对临床病程和生存率的影响。本研究的目的是调查自主神经功能障碍的三个最常见特征的频率，并分析其如何影响生存。30例路易体痴呆和帕金森病痴呆患者被纳入这项前瞻性纵向随访研究。在基线时记录尿失禁和便秘的存在。根据标准化程序在基线、3个月后和6个月后测量血压，在上升后10分钟内测量5次。体位性低血压的定义采用共识定义，持续性体位性低血压定义为5次或以上体位性低血压测量值。在基线后36个月分析生存差异。高频率的持续直立性血压（50%），便秘（30%）和尿失禁（30%）。与无或非持续性体位性低血压患者相比，持续性体位性低血压患者的生存期显著缩短（对数秩x2 = 4.47，p = 0.034）。 与患有孤立性持续性体位性低血压或无体位性低血压的患者相比，除了持续性体位性低血压之外，患有便秘和/或尿失禁的患者的预后较差（Log rank x2 = 6.370，p = 0.041）。 根据我们的发现，自主神经功能障碍的识别在临床实践中似乎非常重要，不仅可以避免福尔斯和其他并发症，而且还可以作为生存的可能预测因素。
Autonomic dysfunction is a well-known feature in neurodegenerative dementias, especially common in α-synucleinopathies like dementia with Lewy bodies and Parkinson's disease with dementia. The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in clinical practice is poorly understood. There are no earlier studies addressing the influence of autonomic dysfunction on clinical course and survival. The aim of this study was to investigate the frequency of the three most common features of autonomic dysfunction and analyze how it affects survival. Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline. There was a high frequency of persistent orthostatic blood pressure (50%), constipation (30%) and incontinence (30%). Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x2 = 4.47, p = 0.034). Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x2 = 6.370, p = 0.041). According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to avoid falls and other complications, but also as a possible predictor of survival.
登录
查看更多内容
影响因子：
5.8
作者：
Heims, HC;Critchley, HD;Cipolotti, L
通讯作者：
Cipolotti, L
影响因子：
48
作者：
Aarsland, Dag;Ballard, Clive;Londos, Elisabet
通讯作者：
Londos, Elisabet
影响因子：
5.1
作者：
Hanyu, H.;Sato, T.;Iwamoto, T.
通讯作者：
Iwamoto, T.
影响因子：
5.9
作者：
Arbogast, Steven D.;Alshekhlee, Amer;Chelimsky, Thomas C.
通讯作者：
Chelimsky, Thomas C.
影响因子：
2.4
作者：
McKeith, IG;Burn, D
通讯作者：
Burn, D