应用Thulesiusi测试法评价帕金森病患者的血压和心率变化

Variability of Blood Pressure and Heart Rate in Patients with Parkinson＇s Disease in Thulesius Test

目的利用Thulesius测试法评价帕金森病患者心血管系统的自主神经功能。方法对18例帕金森患者进行了Thulesius测试法，测量血压和心率随体位的改变，并与性别及年龄匹配的正常对照组比较。结果帕金森患者舒张压在直立后lmin，收缩压在直立后1min、3min和7min时下降均超过对照组，心率比较无显著差异；帕金森组直立3min与直立1min时比较舒张压下降，对照组血压和心率在1、3、7min三个时间段比较差异均不显著。18例帕金森患者中4例（22．2％）出现直立性低血压，但无自觉症状。利用Thulesius诊断图发现帕金森患者中11例（61．1％）存在心血管调节功能障碍，正常人中有3名（18．8％）存在交感神经血压调节功能异常。结论帕金森病人直立后血压下降幅度明显，调节时间延长，与病程及疾病严重程度无关。提示帕金森病变可累及多个系统的自主神经纤维，利用多种检测方法有助于全面了解自主神经系统受损情况。

Objective To assess the autonomic function of cardiovascular system in Parkinson＇s disease（PD） by Thulesius tests.Methods Thulesius tests were studied in eighteen Parkinsonian patients,which needed us to measure the changes in both blood pressure and heart rate with the position.The results were compared with age and sex matched normal controls.Results The fall of systolic blood pressure（SBP） one minute after standing and diastolic blood pressure（DBP） one minute,three minutes and seven minutes after standing in Parkinsonian patients were more than that in healthy controls in Thulesius tests,while the heart rate（HR） has no difference. Orthostatic hypotention was found in four patients（22.2%） but no uncomfortable feelings.Furthermore,there were eleven Parkinsonian patients（61.1%） and three controls（18.8%） who were abnormal in cardiovascular control as to Thulesius diagnosing chart.Conclusions The fall of blood pressure was more and the time of congratulation was longer than the healthy controls in patients with Parkinson＇s disease,and there were no correlation between the results of Thulesius tests and the duration of disease or the serious degree of the disease.From above we can see that the pathology of Parkinson＇s disease can affect autonomic nervous fibers in several systems,and we can know the overall condition of autonomic function by more electrophysiological tests.