Hoeldtke R D, Cavanaugh S T, Hughes J D
Department of Medicine, Temple University School of Medicine, Philadelphia, PA 19140.
Arch Phys Med Rehabil. 1988 Oct;69(10):895-8.
We describe a patient with severe orthostatic hypotension in whom tilt table conditioning had a striking, beneficial effect. Upon presentation, the patient was unable even to sit, and the deconditioning associated with prolonged bed rest worsened his autonomic dysfunction. Although he was sensitive to the pressor effects of vasoconstrictor drugs (dihydroergotamine, caffeine, and a somatostatin analogue), these agents failed to stabilize his walking blood pressure. With drug therapy, however, the patient could maintain an adequate blood pressure while performing isometric exercises on a tilt table, whose angle was gradually increased during three weeks. After this conditioning program, pressor drug therapy made it possible for the patient to walk. Although the physiologic basis for this therapeutic response is unclear, our results indicate that tilt table conditioning may be an important adjunct to drug therapy in patients with severe orthostatic hypotension.
我们描述了一名患有严重直立性低血压的患者，倾斜台训练对其产生了显著的有益效果。初诊时，该患者甚至无法坐起，长期卧床导致的身体失能使他的自主神经功能障碍恶化。尽管他对血管收缩药物（双氢麦角胺、咖啡因和一种生长抑素类似物）的升压作用敏感，但这些药物未能稳定他行走时的血压。然而，通过药物治疗，患者在倾斜台上进行等长运动时能够维持足够的血压，倾斜台的角度在三周内逐渐增加。经过这个训练计划后，升压药物治疗使患者能够行走。虽然这种治疗反应的生理基础尚不清楚，但我们的结果表明，倾斜台训练可能是严重直立性低血压患者药物治疗的重要辅助手段。
