中国人直立不耐受的性别和年龄差异研究  

The gender and age differences in Chinese people with orthostatic intolerance

作　　者：张学军[1,2] 胡春艳[1,3] 王成[1] 吴礼嘉[1] 李雯[1] 林萍[1] 李芳[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41001 [2]湖南澧县人民医院 [3]南华大学附属第二医院

出　　处：《中国实用内科杂志》2011年第5期349-351,共3页Chinese Journal of Practical Internal Medicine

基　　金：湖南省科技厅资助项目(2008SK3111);中南大学研究生学位论文创新基金项目(2009ssxt143)

摘　　要：目的探讨中国人直立不耐受(OI)的性别和年龄差异。方法 2004年1月至2009年6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、头晕、胸闷、胸痛或心悸的患者1069例,年龄平均(19.22±14.80)岁(3～72岁),男506例,女563例。其中<18岁(儿童组)728例,≥18岁(成年组)341例。经常规检查排除器质性心脏病及其他疾病后行直立倾斜试验(HUTT)明确诊断。结果 (1)OI阳性率60.99%,女性大于男性;成人组与儿童组比较差异无统计学意义(P>0.05)。(2)OI类型以血管迷走性晕厥(VVS)多见,其次为体位性心动过速综合征(POTS)及直立性低血压(OH)。VVS混合型比例女性高于男性(P<0.05);心脏抑制型与OH比例在儿童组和成人组之间差异无统计学意义(P>0.05);血管抑制型和混合型比例成人组大于儿童组(P<0.05),而POTS比例则儿童组大于成人组(P<0.01)。(3)女性患者中VVS血管抑制型比例儿童组低于成人组(P<0.05),混合型比例儿童组高于成人组(P<0.01);POTS在儿童组高于成人组(P<0.01)。结论 OI阳性率不存在年龄差异,但女性高于男性。OI类型分布存在一定的年龄和性别差异。Objective To explore the differences in gender and age among Chinese people with orthostatic intolerance （OI）. Methods Between January 2004 and June 2006,1069 patients with unexplained syncope, dizziness,chest distress, chest pain or palpitation were diagnosed or registered to Syncope Clinic of Second Xiangya Hospital, Central South University. These patients comprised 506 males and 563 females （ aged 3 - 72 years old, mean： 19. 22 ±14. 80 ）. Notably, children group included 728 cases （ 〈 18 y） and adult group 341 cases （ ≥ 18 y）. All patients underwent routine checkup to exclude organic heart diseases and other conditions and then received head-up tilt test （HUTT） for a definite diagnosis. Results （ 1 ） The positive rate of OI was 60. 99% in all patients, among whom females had a higher positive rate than males. There was no significant difference in positive rate of OI between the adult and children groups （P 〉 0. 05）. （2） Vasovagal syncope （VVS） was the most common type of OI,followed by POTS and orthostatic hypotension （OH）. Females were higher than males in proportion of mixed type VVS （P 〈 0. 05 ）. There was no difference between children and adult groups in proportion of cardioinhibitory and OH types （ P 〉 0. 05 ）. Compared with each other, adult group had higher proportions of the blood vasodepressor and mixed types （P 〈 0. 05 ）, and children group had higher proportion of POTS （P 〈 0. 01 ）. （3） For female patients, children group had lower proportion of vasodepressor type VVS （ P 〈 0. 05 ）, and adult group had lower proportion of mixed type VVS （P 〈 0. 01 ）. In addition, children group had higher proportion of the POTS than adult group （P 〈 0. 01 ）. Conclusion No difference of age was found in the positive rate of OI, but the positive rate of OI among females was higher than that among males. There were certain age and gender differences in distribution of OI types.

关 键 词：直立不耐受 倾斜试验 年龄 性别 

分 类 号：R5[医药卫生—内科学]