Assadi Farahnak, Czech Kimberly, Palmisano Julie L
Department of Pediatrics, Section of Nephrology, Rush University Medical College, Chicago, IL 60612, USA.
Med Sci Monit. 2004 Dec;10(12):CS77-9.
Autonomic dysreflexia (AD) is a sudden and exaggerated autonomic response to stimuli in patients with spinal cord injuries or dysfunction above the splanchnic sympathetic outflow (T5-T6). Hypertension is a relatively common manifestation of AD.
We describe a case of a young man with T4-T6 spinal cord tumor who developed severe hypertension before any other clinical feature of AD, leading to a subsequent clinical evaluation and the correct diagnosis. Treatment with labetalol was only partially successful in controlling the elevated blood pressure. Hypertension resolved immediately after bladder decompression.
AD manifested by severe hypertension is uncommon. Bladder decompression appears to be safe and effective for management of hypertension in patients with AD.
自主神经反射异常（AD）是指脊髓损伤或在交感神经内脏传出支（T5 - T6）以上存在功能障碍的患者对刺激产生的突然且过度的自主神经反应。高血压是AD相对常见的表现。
我们描述了一名患有T4 - T6脊髓肿瘤的年轻男性病例，该患者在出现AD的任何其他临床特征之前就发生了严重高血压，随后进行了临床评估并得以正确诊断。使用拉贝洛尔治疗仅部分成功控制了血压升高。膀胱减压后高血压立即缓解。
以严重高血压为表现的AD并不常见。膀胱减压似乎是治疗AD患者高血压的安全有效方法。
