原发性高血压与自主神经反射障碍的鉴别:一例报告。

IF 0.7 Q4 CLINICAL NEUROLOGY
Leon Smith, Gerard Weber
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引用次数: 0

摘要

引言:自主性反射障碍(AD)是一种血压严重升高的情况,是脊髓损伤的严重并发症。原发性(原发性)高血压可能表现出与AD相似的血压水平,尽管病因、病理生理学、表现和治疗会有所不同。病例介绍:我们报告了一例74岁的C1脊髓损伤患者,她在康复护理阶段出现原发性(原发性)高血压,需要对自主神经反射障碍进行广泛调查。尽管如此,没有发现根本原因;随后通过24小时动态血压监测证实了原发性高血压。ACE抑制剂的治疗效果良好。讨论:原发性高血压会影响脊柱损伤患者,尽管大多数损伤程度较高(尤其是颈脊髓损伤)的患者预计会出现低静息基线低血压。本案例中介绍了这方面的相关特征;还提出了一套区分原发性高血压和自主神经反射障碍的标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Differentiating essential hypertension from autonomic dysreflexia: a case report.

Differentiating essential hypertension from autonomic dysreflexia: a case report.

Introduction: Autonomic dysreflexia (AD), a condition of critically raised blood pressure, is a severe complication of spinal cord injury. Primary (essential) hypertension may present with similar blood pressure levels to AD, though the causes, pathophysiology, presentation and treatment will differ.

Case presentation: We report a case of a 74-year-old patient with a C1 spinal injury, who developed primary (essential) hypertension during her rehabilitation phase of care, requiring extensive investigations for autonomic dysreflexia. Despite this, no underlying cause was found; essential hypertension was subsequently confirmed with 24-hour ambulatory blood pressure monitoring. Treatment with an ACE inhibitor was introduced to good effect.

Discussion: Essential hypertension can affect patients with spinal injury, even though most patients with higher level injuries (particularly cervical spinal cord injuries) are expected to have low resting baseline hypotension. Relevant features of this are presented within this case; a set of criteria to differentiate essential hypertension from autonomic dysreflexia are also proposed.

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来源期刊
Spinal Cord Series and Cases
Spinal Cord Series and Cases Medicine-Neurology (clinical)
CiteScore
2.20
自引率
8.30%
发文量
92
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