Wieling W, van Lieshout J J, van Leeuwen A M
Department of Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Clin Auton Res. 1993 Feb;3(1):57-65. doi: 10.1007/BF01819146.
A young female with autonomic failure is described. She successfully reduced the symptoms of orthostatic hypotension by application of physical manoeuvres like leg-crossing, bending forward and placing a foot on a chair. The beneficial effects of these manoeuvres can be explained by a small (10-15 mmHg) increase in mean arterial pressure to a level just sufficient to maintain adequate cerebral blood flow. The underlying common mechanism appears to be an increase of thoracic blood volume by translocation of blood from the vascular beds below the diaphragm to the chest. Instruction in these physical manoeuvres should be part of the management programme to reduce the disabilities arising from postural hypotension in patients with autonomic failure.
本文描述了一名患有自主神经功能衰竭的年轻女性。她通过采用诸如交叉双腿、向前弯腰以及将脚放在椅子上等身体动作，成功减轻了直立性低血压的症状。这些动作的有益效果可以通过平均动脉压小幅升高（10 - 15 mmHg）至刚好足以维持充足脑血流量的水平来解释。其潜在的共同机制似乎是通过将血液从横膈膜以下的血管床转移至胸部，从而增加胸腔血容量。对这些身体动作的指导应成为管理方案的一部分，以减少自主神经功能衰竭患者因体位性低血压而产生的残疾。
