Blood pressure adaptation and hormonal regulation after orthostasis in patients with Parkinson's disease
Blood pressure adaptation and hormonal regulation after orthostasis in patients with Parkinson's disease
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DOI：
10.1055/s-2008-1043109
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发表时间：
1996-09-06
影响因子：
0.6
通讯作者：
Zeppezauer, M
中科院分区：
文献类型：
--
作者：
Bellon, AK;Jost, WH;Zeppezauer, M
目的：确定帕金森病（PD）患者是否常发生异常立位调节，是否由异常儿茶酚胺释放引起患者和方法：46例PD患者分别于平卧10 min和站立后1、3、5、7、9 min测定血压和儿茶酚胺浓度（15名女性，31名男性：平均年龄64.3 ± 11.7岁）。结果进行了比较，在一组的27名健康对照组（8名女性，19名男性，平均年龄60.7 +/-10.8岁）。结果：PD患者有显着的低渗循环反应，与降低儿茶酚胺浓度和心率适应;一个异常的直立调节发生在30例。在22例患者中，去甲肾上腺素浓度在站立后9分钟内变化小于200 pg/ml，而仅在4例对照组中观察到激素释放减少，所有对照组均具有正常的立位调节。在PD患者中，最低的肾上腺素升高总是与血压的极高下降相关。平均血压的变化与去甲肾上腺素的升高呈正相关。有没有明显的相关性PD，患者的年龄和疾病的持续时间或严重程度之间的药物治疗。结论：异常直立调节发生在PD比健康人更频繁，并与去甲肾上腺素释放的变化。这表明多系统退化是PD的一个原因。
Objective: To determine whether abnormal orthostatic regulation commonly occurs in patients with Parkinson's disease (PD) and is caused by an abnormal catecholamine release (especially of noradrenaline).Patients and methods: Blood pressure and catecholamine concentration were measured after 10-min recumbency and 1, 3, 5, 7 and 9 min after standing up in 46 patients with PD (15 women, 31 men: mean age 64.3 +/- 11.7 years). Results were compared with those in a group of 27 healthy controls (eight women, 19 men; mean age 60.7 +/- 10.8 years).Results: Among PD patients there were marked hypotonic circulatory reactions, associated with decreased catecholamine concentration and heart rate adaptation; an abnormal orthostatic regulation occurred in 30 patients. In 22 patients noradrenaline concentration changed by less than 200 pg/ml in the 9(th) min after standing up, while a decreased hormonal release was noted in only four of the controls, all of whom had normal orthostatic regulation. In PD patients the lowest adrenaline rise was always associated with an extremely high fall in blood pressure. Changes in mean blood pressure correlated positively with the rise in noradrenaline. There was no demonstrable correlation between medication for PD, age of patient and the duration or severity of the disease.Conclusion: Abnormal orthostatic regulation occurs more frequently in PD than in healthy persons and is associated with changes in noradrenaline release. This suggests multisystem degeneration as a cause of PD.