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中华临床医师杂志(电子版) ›› 2025, Vol. 19 ›› Issue (09) : 720 -724. doi: 10.3877/cma.j.issn.1674-0785.2025.09.012

临床病例分析

年轻女性神经源性直立性低血压合并卧位高血压一例
王美琴, 潘海涛, 李月, 杨洋(), 王砚青   
  1. 210001 南京,中国人民解放军东部战区总医院全科医学科
  • 收稿日期:2025-09-02 出版日期:2025-09-30
  • 通信作者: 杨洋
  • 基金资助:
    中国人民解放军东部战区总医院院管课题(2023LCYYXH009)

Neurogenic orthostatic hypotension with supine hypertension in a young woman: a case report

Meiqin Wang, Haitao Pan, Yue Li, Yang Yang(), Yanqing Wang   

  1. Department of General Practice, General Hospital of Eastern Theater Command of the People's Liberation Army of China, Nanjing 210001, China
  • Received:2025-09-02 Published:2025-09-30
  • Corresponding author: Yang Yang
引用本文:

王美琴, 潘海涛, 李月, 杨洋, 王砚青. 年轻女性神经源性直立性低血压合并卧位高血压一例[J/OL]. 中华临床医师杂志(电子版), 2025, 19(09): 720-724.

Meiqin Wang, Haitao Pan, Yue Li, Yang Yang, Yanqing Wang. Neurogenic orthostatic hypotension with supine hypertension in a young woman: a case report[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(09): 720-724.

神经源性仰卧位高血压是自主神经功能衰竭的一种表现,主要好发于神经源性直立性低血压患者,两者均因自主神经系统结构破坏所致功能损害,使血管收缩功能及血压调节功能障碍所致。神经源性直立性低血压合并卧位高血压患者的血压管理对临床医生极具挑战。且于中老年人中较多见,青年患者罕见,因此其诊断、治疗参考资料较少。本文报道一例以反复发作性头晕和血压波动为主要临床表现的青年女性,予以综合治疗后症状明显好转,为进一步诊治此类疾病提供参考。

Neurogenic supine hypertension, a manifestation of autonomic failure, predominantly occurs in patients with neurogenic orthostatic hypotension. Both conditions result from structural damage to the autonomic nervous system, leading to impaired vascular constriction and blood pressure regulation. Blood pressure management in patients with neurogenic orthostatic hypotension combined with supine hypertension poses significant clinical challenges. While this comorbidity is more common in middle-aged and elderly populations, it is exceptionally rare in young patients, resulting in limited diagnostic and therapeutic references. This article reports the case of a young female patient presenting with recurrent dizziness and blood pressure fluctuations, aiming to provide insights for the diagnosis and management of similar cases.

图1 头颅MRI(磁共振成像)、‌MRA(磁共振血管成像)、肾上腺CT
图2 出院后3个月门诊随访7时、10时、21时、4时自测血压
表1 入院1 d卧立位血压
表2 出院前1 d(治疗后9 d)卧立位血压
表3 出院3个月门诊卧立位血压
表4 出院6月门诊卧立位血压
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