Chaudhuri K R, Maule S, Thomaides T, Pavitt D, Mathias C J
University Department of Clinical Neurology, Institute of Neurology, London, UK.
J Neurol. 1994 Jan;241(3):145-52. doi: 10.1007/BF00868341.
Patients with pure autonomic failure (PAF) and multiple system atrophy (MSA) may complain of feeling light-headed after alcohol ingestion particularly on assumption of the upright posture. The reasons for this have not been investigated. We therefore studied the effects of oral alcohol (40% vodka in sugar-free orange juice) and placebo (juice only) on the systemic and regional (including superior mesenteric artery, SMA) blood flow in nine patients with PAF and six patients with MSA. After alcohol, there was a fall in supine blood pressure (BP) and vasodilatation in the SMA but no change in cardiac output, or forearm muscle and cutaneous blood flow in either PAF or MSA; BP fell further during head-up tilt with no changes in levels of plasma catecholamines. After placebo, there were no changes while supine. We conclude that alcohol lowers supine BP and dilates the SMA with no change in muscle or cutaneous blood flow. Alcohol also enhances the fall in BP during head-up tilt. This may explain the symptoms experienced by PAF and MSA patients after alcohol.
纯自主神经功能衰竭（PAF）和多系统萎缩（MSA）患者在饮酒后可能会抱怨头晕，尤其是在直立姿势时。其原因尚未得到研究。因此，我们研究了口服酒精（40%伏特加加无糖橙汁）和安慰剂（仅橙汁）对9例PAF患者和6例MSA患者的全身及局部（包括肠系膜上动脉，SMA）血流的影响。饮酒后，仰卧位血压（BP）下降，SMA血管扩张，但PAF或MSA患者的心输出量、前臂肌肉和皮肤血流均无变化；头高位倾斜时BP进一步下降，血浆儿茶酚胺水平无变化。服用安慰剂后，仰卧位时无变化。我们得出结论，酒精可降低仰卧位BP并扩张SMA，而肌肉或皮肤血流无变化。酒精还会加剧头高位倾斜时BP的下降。这可能解释了PAF和MSA患者饮酒后的症状。
