Li Lixia, Guo Peng, Ding Duyu, Lian Tenghong, Zuo Lijun, Du Fenghe, Zhang Wei
a Department of Internal Medicine, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.
b Department of Neurology, Beijing Tiantan Hospital, Capital Medical University , Beijing , China.
Neurol Res. 2019 Aug;41(8):734-741. doi: 10.1080/01616412.2019.1610224. Epub 2019 Apr 28.
: This study was designed to investigate clinical symptoms and blood pressure (BP) characteristics in Parkinson's disease (PD) with orthostatic hypotension (OH), and to figure out the influencing factors of PD with OH (PD-OH). : Total 150 PD patients were divided into PD-OH and PD with no OH (PD-NOH) groups based on BP value. Series of scales were used to evaluate clinical symptoms. Twenty-four-hour ambulatory BP monitoring was adopted. : Total 49 PD patients (32.67%) were with OH. PD-OH group had significantly older age, longer disease duration, more diabetes cases, higher levels of fasting blood glucose, higher levels of hemoglobin A1c (HbA1c) and higher levodopa-equivalent daily doses (P < 0.05). Motor symptoms and non-motor symptoms, including autonomic dysfunction, fatigue and cognitive impairment indicated by significantly changed scores of related scales were found in PD-OH group (P < 0.05). PD-OH group had increased BP variability (BPV) and a higher proportion of non-dipper BP pattern (P < 0.05). Binary logistic regression analysis showed that age (B, 0.064; 95% CI, 1.007 ~ 1.128; P < 0.05), HbA1c (B, 1.091; 95% CI, 1.158 ~ 7.648; P < 0.05), and systolic BPV (B, 0.138; 95% CI, 1.004 ~ 1.312; P < 0.05) were independent related factors for PD-OH group. The PD-OH group had significantly compromised daily activities and quality of life (P < 0.05). : Older age, higher levels of HbA1c and increased systolic BPV were the influencing factors of PD-OH patients. Daily activities and quality of life of PD-OH patients were fairly compromised.
本研究旨在调查帕金森病(PD)合并体位性低血压(OH)患者的临床症状和血压(BP)特征,并找出PD合并OH(PD-OH)的影响因素。将150例PD患者根据血压值分为PD-OH组和无OH的PD组(PD-NOH)。使用一系列量表评估临床症状。采用24小时动态血压监测。共有49例PD患者(32.67%)合并OH。PD-OH组患者年龄显著更大、病程更长、糖尿病病例更多、空腹血糖水平更高、糖化血红蛋白(HbA1c)水平更高且左旋多巴等效日剂量更高(P<0.05)。在PD-OH组中发现运动症状和非运动症状,包括自主神经功能障碍、疲劳以及相关量表评分显著变化所提示的认知障碍(P<0.05)。PD-OH组血压变异性(BPV)增加且非勺型血压模式比例更高(P<0.05)。二元逻辑回归分析显示,年龄(B,0.064;95%置信区间,1.0071.128;P<0.05)、HbA1c(B,1.091;95%置信区间,1.1587.648;P<0.05)和收缩压BPV(B,0.138;95%置信区间,1.004~1.312;P<0.05)是PD-OH组的独立相关因素。PD-OH组的日常活动和生活质量显著受损(P<0.05)。年龄较大、HbA1c水平较高和收缩压BPV增加是PD-OH患者的影响因素。PD-OH患者的日常活动和生活质量受到相当程度的损害。