帕金森病餐后低血压的临床研究

Clinical Study of Postprandial Hypotension in Patients with Parkinson’s Disease

目的研究帕金森病餐后低血压(postprandial hypotension,PPH)发生与患者年龄、病期及心率变化等的关系,以预防或减少因血压下降引起的严重不良事件的发生。方法对进食后出现心绞痛、头晕等症状的42例帕金森病患者进行餐前、餐后30min、餐后60min、餐后90min、餐后120min5个时间点的血压及心率监测并记录数据。结果所有患者餐后各时间点舒张压与餐前相比有明显下降,差异有统计学意义(P<0.05);而餐后收缩压下降水平比舒张压更明显(P<0.01);血压下降以餐后90min最明显。年龄65岁以上组患者收缩压下降最大值明显超过65岁以下组(P<0.05)。餐后血压下降同时心率增加,但差异无统计学意义。结论帕金森病患者易发生餐后低血压,以餐后90min最明显,年龄越大血压下降幅度也越大,心率增加不明显。只要加强对本病的认识,积极治疗原发病,可减少严重不良事件的发生。

Objective To investigate the relations among the prevalence of postprandial hypotension and age, disease duration, heart rate variation etc. in patients with Parkinson＇ s disease（ PD）, in hope for decreasing the occurrence of serious adverse events aroused from hypotension. Methods A total of 42 cases of PD with present angina pectoris and dizzy were recruited in this stud- y. The blood pressure and heart rate were tested before meal and at the time point 30-minute, 1-hour, 1.5-hour and 2-hour after meal. Results For all patients, diastolic pressure were remarkably decreased （ P 〈 0.05 ）, and the level of systolic pressure were much remarkably decreased after meal（ P 〈 0.01 ）. The dropping of blood pressure was most remarkable at the time of 1.5 hour after meal. The maximum value of declination of systolic pressure in group A （ age t〉 65 years） were much obvious than that in group B （age 〈 65 years）. The blood pressure decrease was complicated with heart rate increase after meal, but had no statistical significance. Conclusion Patients with developed PD were most vulnerable to postprandial hypotension, especially at 1.5 hour after meal. The descending range of blood pressure was positively correlated to the ages of the patients, but heart rate was not in- creased much. To treat actively the original diseases can decrease the occurrence of seriously bad events.