Kochar M S, Ebert T J, Kotrly K J
J Am Coll Cardiol. 1984 Oct;4(4):802-5. doi: 10.1016/s0735-1097(84)80409-x.
A 33 year old man with a history of recurrent episodes of orthostatic dizziness since adolescence was noted to have a supine blood pressure of 200/120 mm Hg and a standing blood pressure of 90/60 mm Hg. Results of extensive laboratory studies for secondary hypertension were negative. Studies of the autonomic nervous system function revealed normal plasma catecholamines, cold pressor test and response to 4 minute 30% of maximal static handgrip contraction and an appropriate increase in heart rate on intravenous injection of atropine. In contrast, the heart rate response to phenylephrine and sodium nitroprusside infusion, carotid massage and graded neck suction with an airtight chamber was very abnormal, indicating marked dysfunction of the afferent limb of the arterial baroreceptor reflex system. Methyldopa decreased the supine hypertension and increased the standing blood pressure.
一名33岁男性，自青少年期起就有反复发生体位性头晕的病史，其仰卧位血压为200/120 mmHg，站立位血压为90/60 mmHg。针对继发性高血压的广泛实验室检查结果均为阴性。自主神经系统功能研究显示血浆儿茶酚胺正常、冷加压试验正常、对最大静态握力收缩的30%持续4分钟的反应正常，静脉注射阿托品后心率适当增加。相比之下，对去氧肾上腺素和硝普钠输注、颈动脉按摩以及使用密闭腔室进行分级颈部吸引时的心率反应非常异常，表明动脉压力感受器反射系统的传入支存在明显功能障碍。甲基多巴降低了仰卧位高血压并提高了站立位血压。
