Cardiovascular Autonomic Dysfunction in Mild and Advanced Parkinson's Disease.
Cardiovascular Autonomic Dysfunction in Mild and Advanced Parkinson's Disease.
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轻度和晚期帕金森病的心血管自主神经功能障碍。
DOI：
10.14802/jmd.16001
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发表时间：
2016-05
影响因子：
3.9
通讯作者：
Lee KS
中科院分区：
文献类型：
--
作者：
Kim JS;Lee SH;Oh YS;Park JW;An JY;Park SK;Han SR;Lee KS
本研究的目的是调查帕金森病（PD）患者的心血管自主神经功能障碍，并比较药物初治组和多巴胺能药物治疗组之间的心血管自主神经功能障碍。本研究包括188例PD患者和25名年龄匹配的健康对照者，他们接受了直立倾斜试验、24小时动态血压（BP）监测和24小时动态霍尔特监测。在按运动症状严重程度（轻度vs.中度vs.重度）和治疗（药物初治或多巴胺能药物治疗）分类的组中评价自主神经功能测试结果。与健康对照组相比，PD患者中体位性低血压和仰卧位高血压更常见。直立性低血压、仰卧位高血压、夜间高血压和非浸渍的频率在组间无差异。此外，各组间仰卧位BP、直立位BP变化、夜间BP、夜间BP下降或心率变异性无显著差异。心血管自主神经功能障碍并不局限于中度至重度PD患者，并且在高比例的PD患者中在疾病过程的早期开始。此外，多巴胺能药物治疗不影响心血管自主神经功能。
The purpose of the present study was to investigate cardiovascular autonomic dysfunction in patients with Parkinson’s disease (PD) with mild to severe stages of motor symptoms and to compare cardiovascular autonomic dysfunction between drug-naïve and dopaminergic drug-treated groups. This study included 188 PD patients and 25 age-matched healthy controls who underwent head-up tilt-testing, 24-h ambulatory blood pressure (BP) monitoring and 24-h Holter monitoring. Autonomic function test results were evaluated among groups categorized by motor symptom severities (mild vs. moderate vs. severe) and treatment (drug-naïve or dopaminergic drug treatment). Orthostatic hypotension and supine hypertension were more frequent in patients with PD than in healthy controls. The frequencies of orthostatic hypotension, supine hypertension, nocturnal hypertension and non-dipping were not different among groups. Additionally, no significant differences were detected in supine BP, orthostatic BP change, nighttime BP, nocturnal BP dipping, or heart rate variabilities among groups. Cardiovascular autonomic dysfunction is not confined to moderate to severe PD patients, and starts early in the course of the disease in a high proportion of PD patients. In addition, dopaminergic drug treatments do not affect cardiovascular autonomic function.