直立倾斜试验对血管迷走性晕厥反复发作的预测价值  

Prediction value of recurrent syncope in vasovagal syncope with head-up tilt table test

作　　者：王成[1] 何芝香[2] 李茗香[1] 林萍[1] 许毅[1] 郑慧芬[1] 薛小红[1] 谢振武[1] 

机构地区：[1]中南大学湘雅二医院儿科心血管病研究室中南大学儿科学研究所,湖南长沙410011 [2]湖南省儿童医院呼吸免疫科,湖南长沙410007

出　　处：《中国中西医结合急救杂志》2007年第5期275-277,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金："十五"国家科技攻关计划(2004BA720A10);湖南省科技厅资助项目(03SSY4022)

摘　　要：目的:探讨直立倾斜试验(HUTT)对血管迷走性晕厥(VVS)反复发作的预测价值。方法:2001年1月—2005年12月在中南大学湘雅二医院晕厥专科门诊就诊或住院的不明原因晕厥患者共429例。根据临床症状分为偶发晕厥组(晕厥发作仅1次,n=112)与反复晕厥组(晕厥发作超过1次,n=317)。HUTT采用基础直立倾斜试验(BHUT)及舌下含服硝酸甘油倾斜试验(SNHUT),观察两组的阳性率与晕厥发作频次的关系。结果:1BHUT+SNHUT阳性率与晕厥发作频次关系:偶发晕厥组阳性率与反复晕厥组未见差异(36.61%比37.22%),各组男女性别分布亦未见差异(P均>0.05)。2BHUT或SNHUT阳性率与晕厥发作频次关系:在BHUT时偶发晕厥组阳性率低于反复晕厥组(15.09%比33.33%,P>0.05),女性>男性(34.25%比14.15%,P<0.01);在SNHUT时偶发晕厥组阳性率亦低于反复晕厥组(10.69%比40.88%,P>0.05),男女性别未见差异(50.88%比62.35%,P>0.05)。结论:BHUT和(或)SNHUT与晕厥发作频次无明显关系,HUTT阳性率不能预测VVS反复晕厥发作。Objective： To probe predictive value of recurrent syncope in vasovagal syncope （VVS） with head -up tilt table test （HUTT）. Methods： There were 429 （male 163 and female 266） patients of unexplained syncope （UPS） who came from syncope department or were hospitalized in the Second Xiangya Hospital of Central South University, and the basic head -up tilt table test （BHUT） with power tilt table were made for them. Negative cases of BHUT were given sublingual glyceryl trinitrate 0.2 mg and sublingual nitroglycerin, and then head- up tilt table test （SNHUT） was made. The patients were divided into two groups ： occasional syncope group （n= 112, syncope episode only once） and recurrent syncope group （n = 317, syncope episode more than once）. The relation between the positive rate of two groups and syncope frequency was observed. These data were treated statistically by computer with SPSS 11. 0 software. Results： （1）The relation between the positive rate of BHUT ＋ SNHUT and syncope frequency： the positive rate had no significant difference between occasional syncope group and recurrent syncope group （36.6% vs 37.22%, P〉0.05）. There was no significant difference between male and female in occasional and recurrent syncope group （P 〉 0.05）. （2）The relation between the positive rate of either BHUT or SNHUT and syncope frequency： The positive rate was lower in occasional syncope group than in recurrent syncope group （15.09% vs 33.33%, P〉0. 05）, and was more in female than in male （34.25% vs 14.15%, P〈0.01） in BHUT. The positive rate was less in occasional syncope group than in recurrent syncope group （10.69% vs 40.88%, P〉0. 05）, and was of no difference in male and female （50.88% vs 62.35%, P〉0.05） in SNHUT. Conclusion： BHUT and（or） SNHUT are （is） not related to syncope frequency. The positive rate of HUTT can＇t predict recurrent syncope episodes in VVS.

关 键 词：血管迷走性晕厥 反复晕厥 倾斜台试验 诊断 

分 类 号：R541[医药卫生—心血管疾病]