直立倾斜试验后自主神经功能恢复特点初探  

Evaluation of the function recovery of autonomic nerve after tilt test

作　　者：李莉[1] 严松彪[1] 郑平榆[1] 张红[1] 张萍[1] 沈毅[1] 

机构地区：[1]北京友谊医院心血管中心,100050

出　　处：《临床心电学杂志》2008年第5期362-365,共4页Journal of Clinical Electrocardiology

摘　　要：目的通过倾斜试验前后心率变异的变化探讨倾斜试验以及倾斜试验过程中应用异丙肾上腺素(isoproterenol)对自主神经有无较持续的影响及试验的安全性。方法对64例有晕厥史或晕厥前兆患者进行倾斜试验,分为基础倾斜试验(basic tilt table test,BTTT)阳性组5例和阴性组59例,异丙基肾上腺素倾斜试验(isoproterenol tilt table test,ITTT)阳性组31例和阴性组18例。选择倾斜试验前5min及倾斜试验结束后1h5min进行心率变异频域法分析,提取tatol、ulf、vlf、lf、hf、lf/hf6项参数。结果全部病例倾斜试验前后6项参数对比,除vlf外(p=0.011),其余各项无显著性差异,p>0.1。BTTT阳性组倾斜试验前后对比,无显著性差异,p>0.08;BTTT阴性组倾斜试验前后对比,除vlf外(p=0.03),其余各项无显著性差异,p>0.1。ITTT阳性组倾斜试验前后对比,无显著性差异,p>0.1;ITTT阴性组倾斜试验前后对比,除hf外(p=0.013),其余各项无显著性差异,p>0.1。BTTT阳性组与阴性组对比,无显著性差异,p>0.4。ITTT阳性组与阴性组对比,无显著性差异,p>0.1。结论提示倾斜试验前与倾斜试验结束后1h时,心率变异分析除个别参数外,无显著性差异和规律性变化。倾斜试验结束后1h,自主神经的活动已基本恢复到原来状态。倾斜试验以及倾斜试验过程中应用药物(isoproterenol)对自主神经的影响是暂时的,检查后的安全性较好,对检查程序、病人检查后的留观时间有指导意义。Objective To detect iftih table test or its drug（isoproterenol） has any durative effect on parasympathetic system and safety after the test through HRV （heart rate variability） before and after the test. Methods 64 patients with syncope or its auspice who underwent tilt table test were chosen and divided into basic tilt table test（BTTT） positive group with 5 cases, BTTT negtive group with 59 cases, isoproterenol tilt table test（ITTT） positive group with 31 cases and ITTT negtive group with 18 cases. 5 minutes＇ heart rate variability in the frequency domain before and 1 hour after tilt table test was analyzed, 6 indices including tatol, uff, vlf, If, hf, lf/hf were abstracted. Results There was no difference between the 6 indices except vlf of all the patients before and after tilt table test. There was no difference between the indices before and after tilt table test in BTTT positive group, and no difference except vff in BTTT negtive group. There was no difference between the indices before and after tilt table test in ITTT positive group, and no difference except hf in ITTT negtive group. There was no difference between BTIT positive and negtive group, and no difference between ITTT positive and negtive group. Conclusions There was no difference or regular variety in heart rate variability before and after tilt table test. Parasympatheticfunction recovered in 1 hour after tilt table test. The effect of tilt table test and its drug on parasympathetic was transient, which denote the safty after tilt table test and advised the observational time.

关 键 词：晕厥 倾斜试验 心率变异性 

分 类 号：R540.4[医药卫生—心血管疾病]