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青少年脑震荡后体位改变时的症状和直立性低血压。

Symptoms upon postural change and orthostatic hypotension in adolescents with concussion.

机构信息

UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA.

Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA.

出版信息

Brain Inj. 2021 Jan 18;35(2):226-232. doi: 10.1080/02699052.2021.1871951. Epub 2021 Jan 17.

Abstract

: Concussion is associated with dysautonomia, altered blood pressure (BP) control, and may cause Orthostatic Hypotension (OH). We measured prevalence of OH using the 1-minute supine-to-standing OH Test in adolescents with concussion and controls.: Adolescents within 10 days of injury (Concussion Group, n = 297, 15.0 ± 1.7 years, 59% male) were compared with controls (Control Group, n = 214, 15.0 ± 1.5 years, 58% male).: BP, heart rate (HR), and complaints of lightheadedness/dizziness were measured after 2-minute supine and 1-minute standing. Control Group was assessed once. Concussion Group was assessed twice; (1) initial visit (mean 6.0 ± 3 days-since-injury) and (2) after clinical recovery (mean 46.3 ± 42 days-since-injury).: Initial visit; Concussion Group reported feeling lightheaded/dizzy on postural change more often than the Control Group (37% vs 4%,  < .001) but did not differ in meeting standard OH criteria (3% vs 5%,  = .32). Experiencing symptoms did not correlate with meeting OH criteria, but correlated with abnormal vestibulo-ocular reflex. After clinical recovery; Concussion Group did not differ in experiencing lightheaded/dizziness on postural change than controls (4%,  = .65).: Adolescents commonly experience orthostatic intolerance after concussion without meeting the standard criteria for OH.

摘要

脑震荡与自主神经功能紊乱、血压控制改变有关,并可能导致直立性低血压(OH)。我们使用 1 分钟仰卧位至站立位 OH 测试在脑震荡青少年和对照组中测量 OH 的患病率。

在受伤后 10 天内(脑震荡组,n = 297,15.0 ± 1.7 岁,59%男性)与对照组(对照组,n = 214,15.0 ± 1.5 岁,58%男性)进行比较。

测量血压、心率(HR)和头晕/头晕的主诉,在仰卧 2 分钟和站立 1 分钟后进行。对照组仅评估一次。脑震荡组评估两次;(1)初始就诊(平均 6.0 ± 3 天-受伤后)和(2)临床康复后(平均 46.3 ± 42 天-受伤后)。

初始就诊;脑震荡组在姿势改变后报告头晕/头晕的频率高于对照组(37%比 4%,<.001),但不符合 OH 标准(3%比 5%,= 0.32)。出现症状与符合 OH 标准无关,但与异常前庭眼反射有关。临床康复后;脑震荡组在姿势改变后出现头晕/头晕的频率与对照组无差异(4%,= 0.65)。

青少年在脑震荡后常出现直立不耐受,而不符合 OH 的标准。

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