帕金森病患者体位性低血压及餐后低血压的相关危险因素

摘要

目的 探讨帕金森病(PD)患者体位性低血压(0H)和餐后低血压(PPH)的相关危险因素.方法 对55例原发性PD患者(PD组)和35例健康对照者(正常对照组)进行清醒后、早餐前15 min和早餐后60 min卧位和直立位血压的测量,以及PD自主神经症状量表(SCOPA-AUT)评分,并对结果进行比较.分析OH和PPH的相关危险因素.结果 PD组餐后立位收缩压及舒张压显著低于正常对照组(均P＜0.01)；OH、PPH发生率及SCOPA-AUT总分和各项评分均显著高于正常对照组(均P＜0.01).PD患者OH与左旋多巴等效剂量换算呈正相关(P ＜0.05)；PPH与PD病程及OH呈正相关,与SCOPA-AUT中瞳孔调节分数呈负相关(均P＜0.05).结论 PD患者OH和PPH的发生率高.抗PD药物剂量大是PD患者OH发生的危险因素.病程长、OH及瞳孔副交感神经功能损害是发生PPH的危险因素.%Objective To explore the related risk factors of orthostatic hypotension (OH) and postprandial hypotension (PPH) of Parkinson disease (PD).Methods The standing and lying blood pressure at waken up,15 m before breakfast and 60 m after breakfast in 55 primary PD patients (PD group) and 35 normal controls (normal control group) were measured,and scales for outcomes in Parkinson disease-autonomic (SCOPA-AUT) was determined.The results were compared.The correlation risk factors of OH and PPH were analyzed.Results The standing postprandial systolic pressure and diastolic pressure in PD group were significantly lower than those in normal control group (all P ＜ 0.01) ; and incidence of OH,PPH and SCOPA-AUT total score and factor scores in PD group were significantly higher (all P ＜0.01).There was positive correlation between the prevalence of OH and levodopa equivalent dose in PD patients (P ＜ 0.05).PPH was positive correlations with PD pathogenesis and OH,and was negative correlation with score of pupillomotor function in SCOPA-AUT (all P ＜ 0.05).Conclusions The incidence of PPH and OH are high in PD patient.The larger dose of anti-Parkinson disease drug is the risk factor of OH in PD patient.The longer prevalence,OH and the dysfunction of pupil parasympathetic nerve are the risk factors of PPH.