患有仰卧位高血压和直立性低血压的患者：临床难题。
The patient with supine hypertension and orthostatic hypotension: a clinical dilemma.
作者信息
Naschitz J E, Slobodin G, Elias N, Rosner I
机构信息
Department of Internal Medicine A, Bnai-Zion Medical Center and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
出版信息
Postgrad Med J. 2006 Apr;82(966):246-53. doi: 10.1136/pgmj.2005.037457.
Coexistent supine hypertension and orthostatic hypotension (SH-OH) pose a particular therapeutic dilemma, as treatment of one aspect of the condition may worsen the other. Studies of SH-OH are to be found by and large on patients with autonomic nervous disorders as well as patients with chronic arterial hypertension. In medical practice, however, the aetiologies and clinical presentation of the syndrome seem to be more varied. In the most typical cases the diagnosis is straightforward and the responsible mechanism evident. In those patients with mild or non-specific symptoms, the diagnosis is more demanding and the investigation may benefit from results of the tilt test, bedside autonomic tests as well as haemodynamic assessment. Discrete patterns of SH-OH may be recognisable. This review focuses on the management of the patient with coexistent SH-OH.
并存的卧位高血压和直立性低血压（SH-OH）带来了特殊的治疗困境，因为针对该病症一个方面的治疗可能会使另一方面恶化。关于SH-OH的研究大多针对自主神经功能障碍患者以及慢性动脉高血压患者。然而，在医学实践中，该综合征的病因和临床表现似乎更为多样。在最典型的病例中，诊断 straightforward 且责任机制明显。在那些有轻度或非特异性症状的患者中，诊断要求更高，而倾斜试验、床边自主神经测试以及血流动力学评估的结果可能有助于调查。SH-OH的离散模式可能是可识别的。本综述重点关注并存SH-OH患者的管理。 （注：原文中“straightforward”有误，应为“straightforward”，直译为“直接明了的” ）
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