Peterson T, Mathias C J, Alam M, Chandiramani V, Fowler C J
University Department of Clinical Neurology, National Hospital for Neurology, University College London, UK.
Clin Auton Res. 1997 Dec;7(6):299-304. doi: 10.1007/BF02267721.
Simultaneous arterial and urinary bladder pressure measurements were recorded during bladder filling in 21 patients with urinary bladder symptoms; seven patients had autonomic failure due to multiple system atrophy (MSA), seven had spinal cord disease of different aetiology with detrusor hyperreflexia (DH) and seven had no neurological abnormalities. A significant increase in average systolic blood pressure (BP) was recorded on bladder filling in the neurologically intact patients (from 110 to 137 mmHg) and in the patients with spinal cord disease and DH (from 109 to 129 mmHg). In those with MSA, the BP rose in four and fell in three patients. The vesicopressor response during cold receptor-mediated DH was not significantly higher when compared with room-temperature saline and when compared with the BP response during bladder filling in the neurologically intact patients. Finally, intravesical lignocaine retained in the bladder for 15 min did not influence the BP response to cold receptor stimulation in patients with spinal cord disease and DH. These findings and their pathophysiological and clinical implications are discussed.
在21例有膀胱症状的患者膀胱充盈期间记录了动脉压和膀胱压的同步测量结果；7例患者因多系统萎缩（MSA）出现自主神经功能衰竭，7例患有不同病因的脊髓疾病伴逼尿肌反射亢进（DH），7例无神经学异常。在神经功能正常的患者（从110 mmHg升至137 mmHg）以及患有脊髓疾病和DH的患者（从109 mmHg升至129 mmHg）中，记录到膀胱充盈时平均收缩压（BP）显著升高。在患有MSA的患者中，4例血压升高，3例血压下降。与室温生理盐水相比，以及与神经功能正常的患者膀胱充盈期间的血压反应相比，冷感受器介导的DH期间的膀胱升压反应并无显著升高。最后，在患有脊髓疾病和DH的患者中，膀胱内利多卡因保留15分钟并未影响对冷感受器刺激的血压反应。对这些发现及其病理生理和临床意义进行了讨论。
