The Clinical Analysis Of Orthostatic Hypotension In Idiopathic Parkinson Disease And Multiple System Atrophy With Orthostatic Hypotension And The Study Of IPD-OH And MSA-OH By ～1H-MRS And DWI

[OBJECTIVE] 1) To study the relationship between the occurrence of orthostatic hypotension (OH) in idiopathic Parkinson Disease (IPD) and the age of patient, the sicken years, treatment with Madopar, the severity and staging of disease.2) The distinction of clinical features between IPD with OH (IPD-OH) and Multiple System Disease with OH (MSA-OH) were evaluated. The change of blood pressure and heart rate during the first 5 minutes of standing up were analyzed.3) To observe the abnormal of IPD-OH and MSA-OH by 'H-MRS and DWI.[METHODS] 1)The blood pressure of 166 patients with IPD and 38 patients with MSA-OH , and the heart rates of 57 patients with IPD and 15 patients with MSA-OH were measured during the first 5 minutes of standing up. All of IPD patients were divided into four groups according to the descendent degrees of blood pressure. The sicken years, dosage and years of Madopar, were reviewed in IPD patients. The severity and staging of disease were assessed with UPDRS subscale III and V in IPD patients and MSA-OH patients.2) The clinical features of patients with IPD-OH and patients with MSA-OH were compared. 3)8 patients with IPD-OH, 8 patients with MSA-OH and 9 age- and sex-matched healthy volunteers underwent 'H-MRS and DWI. The NAA/Cr ratio of brain stem, putamen and frontal lobe and the ADC value of medulla, pons, putamen and frontal lobe were evaluated in IPD-OH and MSA-OH.Statistical analysis was carried out by SPSS for Windows 13.0.[RESULT] 1) Abnormal blood pressure response was detected in 54.2% patients with IPD. 16.9% patients were reached the OH criterion (the decrease of SBP^30mmHg and the decrease of DBP^15mmHg). The ages, sicken years, Madopar dosage and years, the scales of UPDRS subscale III were increased with the diminution of the blood pressure after standing up. The ages and Madopar dosage of was lower in patients of IPD-0 group than in those of IPD-OH group (P<0. 05) . The scales of UPDRS subscale III was lower in patients of IPD-0, IPD-1 and IPD-2 groups than in those of IPD-OH group (P<0. 05) . The stages of UPDRS subscale V was significant different among groups. The ages ( r=0. 163, P=0. 037 ) , scales(r=0. 501, P=0.001) and stages(r=0.467,P <0. 001) among groups were significant correlated with the grouping factor after controlling for the sicken years with Partial correlation coefficients. The sicken years(r=0. 172, P=0.027) were significant correlated with the grouping factor after controlling for the stages of disease with Partial correlation coefficients. 2) The age, onste age, as well as the decrease of diastolic pressure after standing up were significant different between MSA-OH patients and IPD-OH patients. Neither the scale of UPDRS subscale III, H&R stage nor the decrease of systolic pressure was significant different between two groups. The proportion of sexual disturbance, paruria, dizziness, syncope, falling down and dissymmetry tremor were significant different between two groups. There were not significant different of the perspiration abnormal and constipation between two groups. 3) Compared with control, the NAA/Cr ratios of MSA-OH patients and IPD-OH patients were...