血管迷走性晕厥10年临床研究  

Clinical research in the patients with vasovagal syncope over ten years

作　　者：文川[1] 王成[1] 李雯[1] 吴礼嘉[1] 许毅[1] 林萍[1] 罗海燕[1] 李茗香[1] 曹闽京[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,长沙410011

出　　处：《中国急救医学》2011年第1期25-28,共4页Chinese Journal of Critical Care Medicine

基　　金：湖南省科技厅资助项目（No.2008SK3111）

摘　　要：目的 研究血管迷走性晕厥（VVS）10年临床情况.方法 2000-01～2010-07在我院诊治不明原因晕厥或先兆晕厥患者1782例,根据检查年限分为A组（2000-01～2004-12,n=280）和B组（2005-01～2010-07,n=1502）,根据年龄分为儿童组（〈18岁,n=1180,男450例,女730例）和成人组（≥18岁,n=602,男182例,女420例）.儿童组平均年龄（9.77±3.92）岁,按照年龄段分为4～6岁、7～10岁和11～18岁三个年龄段;成人组平均年龄（40.78±14.05）岁.结果 ①HUTT阳性率：HUTT总阳性率47.7%,其中儿童组和成人组分别为44.3%和54.3%;在儿童和成人中B组较A组均增加（45.7% vs33.3%,61.4% vs33.1%,P〈0.05）.②HUTT阳性率性别比例变化：儿童组和成人组女性均高于男性（32.2% vs12.1%,42.7% vs11.6%,P〈0.05）;在儿童和成人中B组男性和女性均高于A组（分别为12.5% vs9.3%、33.2% vs24.0%,9.8% vs7.3%、51.7% vs25.8%,P〈0.05）.③HUTT反应类型变化：儿童组和成人组血管抑制型〉混合型〉心脏抑制型（P〈0.05）,其中儿童组血管抑制型B组高于A组（33.8% vs19.4%,P〈0.05）;成人组血管抑制型和混合型B组均高于A组（40.1% vs20.5%,18.4% vs9.9%,P〈0.05）.④儿童组HUTT阳性率年龄变化：儿童组11～18岁组〉7～10岁组〉4～6岁组（P〈0.05）.在各年龄段中,4～6岁及11～18岁B组均高于A组（6.2% vs3.9%,23.3% vs21.7%,P〉0.05）,7～10岁组中B组明显高于A组（16.2% vs7.8%,P〈0.05）.结论 VVS患者的阳性率、反应类型在近10年不断发生变化,提示VVS的发生受社会因素、精神因素、生活方式等多种因素的影响.Objective To study the changes in the patients with vasovagal syncope （VVS） over ten years. Methods 2000 - 01 - 2010 - 07, 1782 patients with unexplained syncope or prodromata were enrolled in this study and were divided into two groups, A group （2000 -01 -2004 - 12, n = 280） and B group （2005 -01 -2010 -07, n = 1502） ;and were divided into two groups according to the age, children group （ 〈 18 years old, n = 1180,450 males,730 females, mean （ 9.77±3.92 ） years old ] and adults group[ ≥18 years old, n = 602,182 males,420 females, mean（40.78 ±14.05） years old3. Child patients were divided into three subgroups： 4 -6 years old,7 - 10 years old and 11 - 18 years old. Head -up tilt table test （HUTT） was performed in all the subjects and the VVS was diagnosed if the result was positive. Results （1）The total positive ratio of VVS was 47.7%, and the ratio in children and adults was 44.3% and 54.3% respectively; Compared with A group, the ratio in B group was significant higher in children and adults（45.7% vs 33.3% ,61.4% vs 33. t% ,P 〈0.05）. （2）The positive ratio of VVS in female children and adults was significant higher than that of male children and adults （32.2% vs 12.1% ,42.7% vs 11.6%, P 〈0. 05 ） ; Compared with A group, the ratio of males and females in B group was obviously higher among children and adults（ 12.5% vs 9.3% ,33.2% vs 24.0% ;9.8% vs 7.3% ,51.7% vs 25.8% ,P 〈0.05）. （3）In children and adults, the vasodepressor response type hold the highest ratio in VVS（ P 〈 0.05 ）, and the eardioinhibitory response type hold the lowest ratio （P 〈0.05 ） ; Compared with A group, the ratio of the vasodepressor response type in B group was obviously higher among children and aduhs（33, 8% vs 19.4% ,40.1% vs 20.5%, P 〈 0.05 ） ; Compared with A group, the ratio of the mixed response type in B group was obviously higher in adults （18.4% vs 9.9% ,P 〈0.05）. @In the children, the positive ratio of VVS in 11 -18 years was higher than that in 7

关 键 词：血管迷走性晕厥 直立倾斜试验 年龄 性别 临床研究 

分 类 号：R544.2[医药卫生—心血管疾病]