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帕金森病中的直立性低血压:血压测试与日常生活症状的关系

Orthostatic Hypotension in Parkinson's Disease: The Relation of Blood Pressure Tests and Symptoms in Daily Life.

作者信息

Velseboer Daan C, de Haan Rob J, Post Bart, Krediet C T P Paul, Verberne Hein J, de Bie Rob M A

机构信息

Department of Neurology Academic Medical Center Amsterdam The Netherlands.

Clinical Research Unit Academic Medical Center Amsterdam The Netherlands.

出版信息

Mov Disord Clin Pract. 2016 Aug 19;4(3):329-334. doi: 10.1002/mdc3.12415. eCollection 2017 May-Jun.

Abstract

BACKGROUND

Orthostatic hypotension (OH) is common in Parkinson's disease (PD), but the relation between the results of orthostatic blood pressure tests and orthostatic symptoms in daily life is not clear.

METHODS

We performed a cross-sectional study in an incident nontertiary care cohort of PD patients with additional recruitment of PD patients from our own outpatient clinic. We recruited sex- and age-matched controls. All participants underwent orthostatic blood pressure tests using continuous blood pressure measurements. Orthostatic symptoms experienced in daily life were assessed using autonomic symptom questionnaires (SCOPA-AUT and COMPASS-31).

RESULTS

A total of 83 PD patients and 35 controls were included. Mean patient age was 69.2 years (standard deviation [SD]: 10.0). Mean disease duration was 6.6 years (SD, 0.8). The estimated prevalence of OH in PD was 24.1% (95% confidence interval: 16.2-34.3). There was no significant difference between PD patients with and without OH regarding reported daily orthostatic symptoms. Alternative OH criteria did not substantially improve this.

CONCLUSIONS

Perceived orthostatic symptoms in daily life have no clear association with the results of a single orthostatic blood pressure test. Better diagnostic strategies are needed.

摘要

背景

直立性低血压(OH)在帕金森病(PD)中很常见,但直立性血压测试结果与日常生活中的直立性症状之间的关系尚不清楚。

方法

我们在一个新发病例的非三级护理队列中对PD患者进行了横断面研究,并从我们自己的门诊诊所额外招募了PD患者。我们招募了性别和年龄匹配的对照组。所有参与者都使用连续血压测量进行直立性血压测试。使用自主神经症状问卷(SCOPA-AUT和COMPASS-31)评估日常生活中经历的直立性症状。

结果

共纳入83例PD患者和35例对照组。患者平均年龄为69.2岁(标准差[SD]:10.0)。平均病程为6.6年(SD,0.8)。PD中OH的估计患病率为24.1%(95%置信区间:16.2-34.3)。有OH和无OH的PD患者在报告的日常直立性症状方面没有显著差异。替代的OH标准并没有实质性地改善这一点。

结论

日常生活中感知到的直立性症状与单次直立性血压测试结果没有明确关联。需要更好的诊断策略。

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