Department of Neurology, Faculty of Medicine, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı, No:1 Bağcılar, 34214, Istanbul, Turkey.
Acta Neurol Belg. 2020 Aug;120(4):915-920. doi: 10.1007/s13760-019-01113-7. Epub 2019 Mar 7.
Nocturnal blood pressure (BP) changes are an indicator of autonomic dysfunction. We aim to investigate the correlation between nocturnal blood pressure (BP) variability, vitamin D levels and Parkinson's disease severity (PD) in this study. Thirty-five patients with PD participated in the study. Disease severity was evaluated by United Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr Scale (HYS). Equivalent levodopa dose was calculated and 25-hydroxyvitamin D levels were measured. The Non-Motor Symptom Questionnaire (NMSQ) was applied to all patients. Ambulatory BP monitoring for 24 h was established. Patients were divided into three groups according to nocturnal BP results: dippers (normal finding-a decline in mean nighttime BP of more than 10%); non-dippers (pathological-a decline in mean nighttime BP of less than 10%); reverse dippers (pathological-an increase in mean nighttime BP) .The mean score of the NMSQ was higher in the group with HYS > 2 (p = 0.050). Four patients were dipper, 17 patients were non-dipper and 16 patients were reverse dipper. There was no significant difference between the three groups in terms of age, gender, disease duration, age of the disease onset, disease stage, disease duration, dopamine agonist usage, levodopa equivalent dose, vitamin D level and NMSQ scores. NMSQ scores are high in advanced PD. Ambulatory BP monitoring is useful in detecting autonomic dysfunction. The number of patients with non-dipping and reverse dipping is high in PD, independent from PD severity, drug dose, vitamin D and the other NMS symptoms.
夜间血压（BP）变化是自主神经功能障碍的指标。本研究旨在探讨夜间血压（BP）变异性、维生素 D 水平与帕金森病严重程度（PD）的相关性。35 例 PD 患者参与本研究。采用统一帕金森病评定量表（UPDRS）和 Hoehn 和 Yahr 量表（HYS）评估疾病严重程度。计算等效左旋多巴剂量，测量 25-羟维生素 D 水平。对所有患者应用非运动症状问卷（NMSQ）。建立 24 小时动态血压监测。根据夜间 BP 结果将患者分为三组：杓型（正常发现-夜间平均 BP 下降超过 10%）；非杓型（异常-夜间平均 BP 下降低于 10%）；反杓型（异常-夜间平均 BP 升高）。HYS＞2 组的 NMSQ 平均评分较高（p=0.050）。4 例为杓型，17 例为非杓型，16 例为反杓型。三组间在年龄、性别、病程、发病年龄、疾病分期、病程、多巴胺激动剂使用、左旋多巴等效剂量、维生素 D 水平和 NMSQ 评分方面无显著差异。晚期 PD 患者的 NMSQ 评分较高。动态血压监测有助于发现自主神经功能障碍。PD 患者中非杓型和反杓型的比例较高，与 PD 严重程度、药物剂量、维生素 D 和其他 NMS 症状无关。
