PDF(Pubmed)
Abstract：
Postprandial hypotension is a type of autonomic dysfunction where there is a decrease in systolic blood pressure of >20 mm HG within 2 h after eating thought to be due to poor cardiovascular compensation for splanchnic blood pooling that occurs with meals. This form of autonomic dysfunction is underdiagnosed in patients with spinal cord injury, likely in part because it can be asymptomatic.
26-year-old with complete cervical spinal cord injury (SCI) presented with neck pain described as severe 10/10 pain, which felt like \"a rope around his neck.\" Pain came on during and after meals and was associated with a feeling of pressure behind his eyes, white spots in his vision along with feeling as if he was going to pass out. The caregiver noted a systolic blood pressure drop by about 30-40 points with meals and lost weight due to avoiding eating. A diagnosis of post-prandial hypotension (PPH) was made and Acarbose was started at a low dose 25 mg three times per day with meals. During follow up, the patient reported complete resolution of drops of blood pressure, neck pain, and all associated symptoms. The patient was able to eat comfortably and gained weight.
There are few case reports on PPH in SCI and none looking at acarbose on a young, nondiabetic person with SCI. Clinicians should be aware that PPH can occur in young otherwise healthy people with SCI. Further research is needed on PPH, including the use of acarbose, in the SCI population.
26-year-old with complete cervical spinal cord injury (SCI) presented with neck pain described as severe 10/10 pain, which felt like \"a rope around his neck.\" Pain came on during and after meals and was associated with a feeling of pressure behind his eyes, white spots in his vision along with feeling as if he was going to pass out. The caregiver noted a systolic blood pressure drop by about 30-40 points with meals and lost weight due to avoiding eating. A diagnosis of post-prandial hypotension (PPH) was made and Acarbose was started at a low dose 25 mg three times per day with meals. During follow up, the patient reported complete resolution of drops of blood pressure, neck pain, and all associated symptoms. The patient was able to eat comfortably and gained weight.
There are few case reports on PPH in SCI and none looking at acarbose on a young, nondiabetic person with SCI. Clinicians should be aware that PPH can occur in young otherwise healthy people with SCI. Further research is needed on PPH, including the use of acarbose, in the SCI population.
摘要：
背景：餐后低血压是一种自主神经功能障碍，在进食后2小时内收缩压下降>20mmHG，这被认为是由于进食时内脏积血的心血管补偿不足。这种形式的自主神经功能障碍在脊髓损伤患者中诊断不足，可能部分是因为它可以是无症状的。
方法：26岁的完全性颈脊髓损伤（SCI），表现为严重的10/10疼痛的颈部疼痛，感觉就像一根绳子套在他的脖子上。“疼痛出现在饭后和饭后，并与他的眼睛后面的压力的感觉有关，他的视力中出现了白点，感觉好像要昏倒了。护理人员注意到，随着进餐，收缩压下降了约30-40点，并且由于避免进食而减轻了体重。做出餐后低血压（PPH）的诊断，并以低剂量25mg开始阿卡波糖，每天三餐。随访期间,患者报告血压下降完全缓解，颈部疼痛,和所有相关症状。患者能够舒适地进食并且体重增加。
结论：在SCI中很少有关于PPH的病例报告，在年轻人身上没有关于阿卡波糖的病例报告，非糖尿病患者SCI。临床医生应该意识到PPH可能发生在年轻的SCI患者中。需要对PPH进行进一步的研究，包括阿卡波糖的使用,在SCI人群中。
方法：26岁的完全性颈脊髓损伤（SCI），表现为严重的10/10疼痛的颈部疼痛，感觉就像一根绳子套在他的脖子上。“疼痛出现在饭后和饭后，并与他的眼睛后面的压力的感觉有关，他的视力中出现了白点，感觉好像要昏倒了。护理人员注意到，随着进餐，收缩压下降了约30-40点，并且由于避免进食而减轻了体重。做出餐后低血压（PPH）的诊断，并以低剂量25mg开始阿卡波糖，每天三餐。随访期间,患者报告血压下降完全缓解，颈部疼痛,和所有相关症状。患者能够舒适地进食并且体重增加。
结论：在SCI中很少有关于PPH的病例报告，在年轻人身上没有关于阿卡波糖的病例报告，非糖尿病患者SCI。临床医生应该意识到PPH可能发生在年轻的SCI患者中。需要对PPH进行进一步的研究，包括阿卡波糖的使用,在SCI人群中。
