Canosa-Hermida Eva, Mondelo-García Cristina, Ferreiro-Velasco María Elena, Salvador-de la Barrera Sebastián, Montoto-Marqués Antonio, Rodríguez-Sotillo Antonio, Vizoso-Hermida José Ramón
a Spinal Cord Injury Unit.
b Pharmacy Service, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC). Sergas. Universidade da Coruña (UDC) , Coruña , Spain.
J Spinal Cord Med. 2018 Jan;41(1):115-118. doi: 10.1080/10790268.2016.1274093. Epub 2017 Jan 24.
Orthostatic hypotension (OH) is a common complication in patients with a spinal cord injury, mainly affecting complete injuries above neurological level T6. It is generally more severe during the acute phase but can remain symptomatic for several years.
A 65-year-old male with a grade ASIA A post-traumatic cervical spinal cord injury, at neurological level C4, presenting with symptomatic refractory OH. Increased blood pressure (BP) levels and an overall clinical improvement was observed after administering an increasing dose of droxidopa. Treatment was started at a dose of 100 mg twice daily (bid), one to be taken upon rising in the morning and another one in the afternoon, at least three hours before bedtime. According to the patient's symptomatic response, each individual dose was increased by 100 mg at 48-hour intervals. Both increased mean BP levels and a subjective symptomatic improvement were evidenced at a dose of 300 mg bid.
Treatment with droxidopa increases BP levels and improves symptoms related to refractory OH using all physical and pharmacological measures available. It could therefore constitute an effective alternative treatment for OH in patients with a spinal cord injury.
直立性低血压（OH）是脊髓损伤患者的常见并发症，主要影响神经平面T6以上的完全性损伤。通常在急性期更为严重，但症状可能会持续数年。
一名65岁男性，创伤后颈髓损伤，ASIA A级，神经平面C4，出现症状性难治性OH。在给予递增剂量的屈昔多巴后，观察到血压（BP）水平升高及整体临床改善。治疗开始时剂量为每日两次，每次100mg（bid），一次在早晨起床时服用，另一次在下午服用，至少在睡前三小时。根据患者的症状反应，每隔48小时将单次剂量增加100mg。在每日两次300mg的剂量时，平均BP水平升高及主观症状改善均得到证实。
使用所有可用的物理和药物措施，屈昔多巴治疗可提高BP水平并改善与难治性OH相关的症状。因此，它可能成为脊髓损伤患者OH的一种有效替代治疗方法。
