Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA.
Parkinsonism Relat Disord. 2011 Sep;17(8):625-8. doi: 10.1016/j.parkreldis.2011.05.020.
Non-motor symptoms in Parkinson disease (PD) have been increasingly recognized as a major cause of declining health-related quality of life. We aimed to determine the prevalence of symptomatic orthostatic hypotension (OH) in patients with PD and atypical parkinsonism, and to evaluate the risk factors for OH in this population. We reviewed the records of 1318 patients diagnosed with PD or atypical parkinsonism at the Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine. The frequency of symptomatic OH was 81% (21/26) in patients with multiple system atrophy (MSA), 18% (198/1125) of PD patients, and 19% (31/167) of patients with non-MSA atypical parkinsonism. Among PD patients, those with symptoms of OH were significantly older (p = 0.001), had more advanced Hoehn & Yahr stage (p = 0.007), a longer duration of PD symptoms (p = 0.031), and a greater range between their highest and lowest sitting systolic and diastolic BPs (p = 0.0001) over time. In the atypical parkinsonism group, excluding MSA, patients with symptoms of OH were taking more anti-hypertensive medications than those without symptoms of OH (p = 0.043). On the other hand, MSA patients with symptoms of OH were less likely to be taking anti-hypertensive medications than those without symptoms (p = 0.035). In conclusion, symptomatic OH is a common cause of disability in patients with PD, atypical parkinsonian disorders, and especially in patients with MSA.
帕金森病（PD）中的非运动症状已日益被视为导致健康相关生活质量下降的主要原因。我们旨在确定 PD 和非典型帕金森病患者中症状性直立性低血压（OH）的患病率，并评估该人群中 OH 的危险因素。我们回顾了贝勒医学院帕金森病中心和运动障碍诊所诊断为 PD 或非典型帕金森病的 1318 名患者的记录。多系统萎缩（MSA）患者中症状性 OH 的频率为 81%（21/26），PD 患者为 18%（198/1125），非 MSA 非典型帕金森病患者为 19%（31/167）。在 PD 患者中，有 OH 症状的患者明显更年长（p=0.001），Hoehn & Yahr 分期更高（p=0.007），PD 症状持续时间更长（p=0.031），最高和最低坐姿收缩压和舒张压之间的差值更大（p=0.0001）。在非 MSA 非典型帕金森病组中，除 MSA 外，有 OH 症状的患者比无 OH 症状的患者服用更多的抗高血压药物（p=0.043）。另一方面，有 OH 症状的 MSA 患者服用抗高血压药物的可能性低于无症状患者（p=0.035）。总之，症状性 OH 是 PD、非典型帕金森病患者，尤其是 MSA 患者残疾的常见原因。
