Ho R M, Freed M M
Department of Rehabilitation Medicine, Boston University Medical Center, MA 02118-2393.
Arch Phys Med Rehabil. 1991 Sep;72(10):743-6.
The development of persistent hypertension in young, previously healthy paraplegic individuals is unusual; it could be postulated that hypertension is a cardiovascular response peculiar to patients who sustained spinal cord injury after surgical repair of the aorta with trauma-related injuries. In a retrospective study of 712 patients sustaining spinal cord injury during the last decade, seven sustained paraplegia after aortic repair that was necessitated by trauma-related injuries. Despite the low incidence of new-onset hypertension in paraplegic patients, five of the seven developed hypertension, of which three required chronic antihypertensive medications. It is well documented that patients with lesions of the neuraxis above the sixth thoracic segment are prone to the phenomenon of autonomic hyperreflexia. This results from interruption of the baroreceptor reflex and the descending tracts of the spinal cord. There is evidence that the renin-angiotensin system, catecholamines, and receptor-site activity play an important role in the control of blood pressure in spinal cord injured patients. Additional investigation of this rare subgroup of spinal cord injured patients may further illuminate the effect of spinal cord injury on autonomic control of the cardiovascular system.
年轻且既往健康的截瘫患者出现持续性高血压的情况较为罕见；据推测，高血压是主动脉因创伤相关损伤进行手术修复后脊髓损伤患者特有的一种心血管反应。在一项对过去十年间712例脊髓损伤患者的回顾性研究中，有7例因创伤相关损伤接受主动脉修复术后出现截瘫。尽管截瘫患者新发高血压的发生率较低，但这7例中有5例出现了高血压，其中3例需要长期服用抗高血压药物。有充分的文献记载，胸段第六节段以上神经轴损伤的患者容易出现自主神经反射亢进现象。这是由压力感受器反射和脊髓下行传导束中断所致。有证据表明，肾素 - 血管紧张素系统、儿茶酚胺和受体位点活性在脊髓损伤患者的血压控制中起重要作用。对这一罕见的脊髓损伤患者亚组进行进一步研究，可能会进一步阐明脊髓损伤对心血管系统自主控制的影响。
