Krum H, Louis W J, Brown D J, Howes L G
Department of Clinical Pharmacology, Austin Hospital, Heidelberg, Victoria, Australia.
Clin Auton Res. 1992 Apr;2(2):83-8. doi: 10.1007/BF01819662.
The ability of the alpha-1 adrenoceptor antagonist, prazosin, to reduce the severity and duration of episodes of autonomic dysreflexia was studied in cervical and high thoracic spinal cord injury patients with documented episodes of autonomic dysreflexia. Sixteen patients participated in a double blind parallel group study comparing prazosin 3 mg b.d. with placebo given for 2 weeks. Both groups were matched for age, sex and baseline severity of autonomic dysreflexia episodes. Prazosin was well tolerated and did not produce a significant lowering of resting blood pressure. Compared to baseline measurements, patients allocated to prazosin therapy were found to have fewer severe episodes of autonomic dysreflexia and during these episodes to have significant reductions in average rise in systolic and diastolic blood pressure, symptom duration and requirement for acute antihypertensive medication. The severity of headache during individual autonomic dysreflexia episodes was also diminished with prazosin therapy. No symptom parameter was significantly altered by placebo therapy. It is concluded that prazosin is superior to placebo in the prophylactic management of autonomic dysreflexia and that these findings are consistent with suggestions that alpha-1 adrenoceptors play an important role in the pathogenesis of this syndrome.
在有自主神经反射异常发作记录的颈髓和高位胸髓损伤患者中，研究了α-1肾上腺素能受体拮抗剂哌唑嗪减轻自主神经反射异常发作的严重程度和持续时间的能力。16名患者参与了一项双盲平行组研究，比较每日两次服用3毫克哌唑嗪与服用2周安慰剂的效果。两组在年龄、性别和自主神经反射异常发作的基线严重程度方面相匹配。哌唑嗪耐受性良好，未导致静息血压显著降低。与基线测量值相比，接受哌唑嗪治疗的患者自主神经反射异常的严重发作次数较少，并且在这些发作期间，收缩压和舒张压的平均升高幅度、症状持续时间以及急性抗高血压药物的需求均显著降低。哌唑嗪治疗还减轻了个体自主神经反射异常发作期间的头痛严重程度。安慰剂治疗未使任何症状参数发生显著改变。得出的结论是，在自主神经反射异常的预防性治疗中，哌唑嗪优于安慰剂，并且这些发现与α-1肾上腺素能受体在该综合征发病机制中起重要作用的观点一致。
