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吉林医药学院附属医院神经内科,吉林 132000
赵丽丽,Email:jyfy465hsh@163.com,研究方向:帕金森病及运动障碍疾病临床与基础研究。
姜立刚,Email:784057398@qq.com。
收稿:2026-01-06,
修回:2026-03-05,
录用:2026-03-23,
纸质出版:2026-05-28
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赵丽丽,姜立刚.直立倾斜试验在帕金森病自主神经损害诊断中的应用[J].重庆医科大学学报,2026,51(5):603-607.
Zhao Lili,Jiang Ligang.Clinical application of the head-up tilt test in diagnosis of autonomic nerve dysfunction in Parkinson’s disease[J].Journal of Chongqing Medical University,2026,51(5):603-607.
赵丽丽,姜立刚.直立倾斜试验在帕金森病自主神经损害诊断中的应用[J].重庆医科大学学报,2026,51(5):603-607. DOI: 10.13406/j.cnki.cyxb.004081.
Zhao Lili,Jiang Ligang.Clinical application of the head-up tilt test in diagnosis of autonomic nerve dysfunction in Parkinson’s disease[J].Journal of Chongqing Medical University,2026,51(5):603-607. DOI: 10.13406/j.cnki.cyxb.004081.
帕金森病(Parkinson’s disease,PD)是一类以黑质多巴胺能神经元变性死亡为主的中枢神经系统退行性疾病,自主神经损害是其最常见的非运动症状之一,占PD患者50%~80%,严重影响患者生活质量,增加跌倒、心血管事件等不良结局风险。直立倾斜试验是最可靠的自主神经功能检测方法之一,通过模拟直立体位诱发血流动力学变化来发现患者隐匿的自主神经调节异常。本文综述PD自主神经损害的病理和临床特点,介绍直立倾斜床原理,重点阐述直立倾斜试验对PD自主神经损害诊断的敏感性以及临床应用价值,并与其他检测手段比较,指出现存问题和改进方向,为PD自主神经损害的早期筛查、量化、疗效评估和个性化治疗提供依据。
Parkinson’s disease (PD) is a central nervous system degenerative disease characterized by the degeneration and death of dopaminergic neurons in the substantia nigra,and autonomic nerve dysfunction is one of the most common non-motor symptoms of PD,accounting for 50%-80% of all patients,which seriously affects the quality of life of patients and increases the risk of adverse outcomes such as falls and cardiovascular events. The head-up tilt test is one of the most reliable method for assessing autonomic nervous function,which can detect hidden autonomic dysregulation by simulating the hemodynamic changes induced by the upright position. This article reviews the pathological and clinical features of autonomic nerve dysfunction in PD,introduces the principle of the head-up tilt table,and highlights the sensitivity and clinical application value of the head-up tilt test in the diagnosis of autonomic nerve dysfunction in PD. It also compares this test with other detection methods and points out the existing problems and the directions for further improvement,in order to provide a basis for early screening,quantification,outcome assessment,and individualized treatment of autonomic nerve dysfunction in PD.
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