Thomaides T, Bleasdale-Barr K, Chaudhuri K R, Pavitt D, Marsden C D, Mathias C J
Autonomic Unit, University Department of Clinical Neurology, Institute of Neurology, Queen Square, United Kingdom.
Neurology. 1993 May;43(5):900-4. doi: 10.1212/wnl.43.5.900.
We investigated the effect of a balanced liquid meal on blood pressure (BP) and heart rate (with patients supine and during head-up tilt), and on levels of plasma catecholamines, glucose, and insulin, in patients with idiopathic Parkinson's disease (IPD), multiple system atrophy (MSA), pure autonomic failure (PAF), and in healthy subjects (controls). After food, supine BP fell in IPD, but to a greater extent in MSA and PAF. In controls, BP was unchanged. Head-up tilt did not lower BP in IPD and controls, but there was a postprandial fall to lower levels in both MSA and PAF. Plasma norepinephrine levels rose in IPD pre- and postprandially during tilt, but were unchanged in MSA and PAF. These data suggest that in IPD, food causes a smaller fall in supine BP than in MSA and PAF. In IPD, as in controls, food does not induce or unmask postural hypotension, unlike in MSA and PAF, in which BP falls to even lower levels. There are therefore differences in the responses to food ingestion between these groups. This may be of value in separation of these disorders at an early stage.
我们研究了均衡流食对特发性帕金森病（IPD）、多系统萎缩（MSA）、单纯自主神经功能衰竭（PAF）患者以及健康受试者（对照组）的血压（BP）、心率（患者仰卧位及头高位倾斜时）、血浆儿茶酚胺、葡萄糖和胰岛素水平的影响。进食后，IPD患者仰卧位血压下降，但MSA和PAF患者下降幅度更大。对照组血压无变化。头高位倾斜时，IPD患者和对照组血压未降低，但MSA和PAF患者餐后血压均降至更低水平。倾斜期间，IPD患者仰卧位前后血浆去甲肾上腺素水平升高，而MSA和PAF患者则无变化。这些数据表明，与MSA和PAF相比，IPD患者进食后仰卧位血压下降幅度较小。与对照组一样，IPD患者进食不会诱发或掩盖体位性低血压，但MSA和PAF患者进食后血压会降至更低水平。因此，这些组对食物摄入的反应存在差异。这可能有助于在早期区分这些疾病。
