Grubb B P, Klingenheben T
Department of Medicine, Medical College of Ohio, Richard D. Ruppert Health Center, Toledo, USA.
Med Klin (Munich). 2000 Aug 15;95(8):442-6. doi: 10.1007/s000630050004.
Since the renaissance of tilt table testing in clinical cardiology some 15 years ago, the syndromes of autonomic dysfunction with orthostatic intolerance underwent improved differentiation and classification. In the present review a variant of autonomic dysfunction with orthostatic intolerance--POTS (postural orthostatic tachycardia syndrome)--will be discussed.
The affected patients present with orthostatic intolerance, postural tachycardia, exercise intolerance, fatigue, dizziness and in some cases with other dysautonomic symptoms such as gastrointestinal or sudomotor dysfunction. Together with the clinical history, tilt table testing is the cornerstone of diagnostic evaluation by which the syndrome can be distinguished from typical neurocardiogenic disorders. POTS is characterized by different subtypes; accordingly, therapy for relief of symptoms is variable and includes beta blockers for patients with the hyperadrenergic type and alphamimetics for those with partial dysautonomia.
Although it is now possible to differ POTS from other forms of autonomic dysfunction, further research is warranted to clarify the pathophysiology of this syndrome and its subtypes and to improve therapeutic interventions.
自大约15年前临床心脏病学中倾斜试验复兴以来，伴有直立不耐受的自主神经功能障碍综合征得到了更好的鉴别和分类。在本综述中，将讨论一种伴有直立不耐受的自主神经功能障碍变体——体位性直立性心动过速综合征（POTS）。
受影响的患者表现为直立不耐受、体位性心动过速、运动不耐受、疲劳、头晕，在某些情况下还伴有其他自主神经功能障碍症状，如胃肠或汗腺功能障碍。结合临床病史，倾斜试验是诊断评估的基石，通过该试验可将该综合征与典型的神经心源性疾病区分开来。POTS具有不同的亚型；因此，缓解症状的治疗方法各不相同，对于高肾上腺素能型患者包括使用β受体阻滞剂，对于部分自主神经功能障碍患者包括使用α受体激动剂。
尽管现在能够将POTS与其他形式的自主神经功能障碍区分开来，但仍需要进一步研究以阐明该综合征及其亚型的病理生理学，并改善治疗干预措施。
