Senard J M, Raï S, Lapeyre-Mestre M, Brefel C, Rascol O, Rascol A, Montastruc J L
Laboratoire de Pharmacologie Médicale et Clinique, INSERM U317, Faculté de Médecine, Purpan University Hospital, Toulouse, France.
J Neurol Neurosurg Psychiatry. 1997 Nov;63(5):584-9. doi: 10.1136/jnnp.63.5.584.
To investigate the prevalence of orthostatic hypotension and the nature of the postural events related to a fall in blood pressure in patients with Parkinson's disease.
Blood pressure was measured first in a supine position after a rest of at least 15 minutes and every minute during 10 minutes of an active standing up procedure. Orthostatic hypotension was considered as present when a fall of at least 20 mm Hg of systolic blood pressure was recorded. Postural events which occurred during the standing test were identified from a questionnaire and self reporting. Statistical analysis was performed to determine the relation between orthostatic hypotension and disease characteristics (duration, severity) and the use of antiparkinsonian drugs. Ninety one consecutive patients with Parkinson's disease (48 women, 43 men, mean age 66 (SD 9) years) participated to the study.
A fall of at least 20 mm Hg of systolic blood pressure was found in 58.2% of the patients. Orthostatic hypotension was asymptomatic in 38.5% and associated with postural events in 19.8% of the patients. Symptomatic (but not asymptomatic) orthostatic hypotension was related to duration and severity of the disease and with the use of higher daily levodopa and bromocriptine doses. The analysis of the relation between the postural symptoms (and the need for standing test abortion) with the fall in systolic blood pressure allowed the identification of six clinical criteria specific of orthostatic hypotension. A direct relation between the postural changes in systolic blood pressure and the number of clinical events in this clinical scale was found.
The frequency of orthostatic hypotension in Parkinson's disease is high and it is possible to establish a clinical rating scale which could be used to assess the effects of drugs employed in the management of orthostatic hypotension.
调查帕金森病患者体位性低血压的患病率以及与血压下降相关的姿势性事件的性质。
在至少休息15分钟后先测量仰卧位血压，然后在主动站立10分钟过程中每分钟测量一次血压。当收缩压下降至少20 mmHg时，认为存在体位性低血压。通过问卷调查和自我报告确定站立测试期间发生的姿势性事件。进行统计分析以确定体位性低血压与疾病特征（病程、严重程度）以及抗帕金森药物使用之间的关系。91例连续的帕金森病患者（48例女性，43例男性，平均年龄66（标准差9）岁）参与了该研究。
58.2%的患者收缩压下降至少20 mmHg。38.5%的患者体位性低血压无症状，19.8%的患者与姿势性事件相关。有症状（而非无症状）的体位性低血压与疾病的病程和严重程度以及每日较高剂量的左旋多巴和溴隐亭的使用有关。对姿势性症状（以及中止站立测试的必要性）与收缩压下降之间关系的分析，确定了体位性低血压的六个特定临床标准。发现该临床量表中收缩压的姿势性变化与临床事件数量之间存在直接关系。
帕金森病患者体位性低血压的发生率很高，并且有可能建立一种临床评分量表，可用于评估用于治疗体位性低血压的药物的效果。
