倾斜试验合并舌下含化硝酸异山梨酯对血管迷走性晕厥的诊断价值(英文)  

Diagnostic value of head-up tilt test with sublingual isosorbide dinitrate in patients with vasovagal syncope

作　　者：汪顺银[1] 梁俊杰[1] 张清齐[1] 刘艳[1] 

机构地区：[1]佛山市第二人民医院心血管内二科,广东佛山528000

出　　处：《心血管康复医学杂志》2013年第1期83-86,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：Foshan municipal bureau of science and technology project(200908006)~~

摘　　要：目的:探讨直立倾斜试验(HUTSI)合并舌下含化硝酸异山梨酯对血管迷走性晕厥(VVS)的诊断价值。方法:52例VVS患者(VVS组)及38例无晕厥病史的健康体检者(正常对照组)先进行基础直立倾斜试验(BHUT),阴性者再进行HUTSI试验。结果:BHUT阳性诱发率VVS组为25%(13/52)而正常对照组为0;阳性者由平卧位至HUT阳性时心率及平均动脉压均明显下降[(73.1±8.5)次/min比(56.2±11.2)次/min,(81.2±10.8)mmHg比(50.2±10.4)mmHg,P均<0.05]。VVS组剩余39例进行HUTSI试验,阳性者21例,阳性诱发率为53.9%而正常对照组为5.3%(2/38),HUTSI阳性者由平卧位至HUT阳性时心率及平均动脉压也明显下降[(65.2±7.5)次/min比(52.9±10.5)次/min,(78.3±10.7)mmHg比(48.8±11.2)mmHg,P<0.01,<0.05]。HUTSI阳性组从倾斜开始至出现阳性反应的时间比BHUT阳性组明显缩短[(10.8±9.3)min比(21.1±11.5)min,P<0.05]。VVS组仅2例而正常对照组仅1例出现头痛、面红等副作用,但均能坚持试验。结论:直立倾斜试验合并舌下含化硝酸异山梨酯诊断血管迷走性晕厥,敏感性好,特异性高,而且简便省时,副作用少,是一项实用的检查技术。Objective： To explore the diagnostic value of head-up tilt test with sublingual isosorbide dinitrate （HUTSI） in patients with vasovagal syncope （VVS）. Methods： A total of fifty-two consecutive patients with clinically vasova- gal syncope （VVS group） and thirty-eight control subjects without prior experience of syncope （normal control group） were evaluated by baseline head-up tilt table test （BHUT）, then the BHUT negative subjects underwent HUTSI test. Results： （1） Positive BHUT test rate of VVS group and normal control group were 25% （13/52） and 0 respectively; from supine to HUT positive, there were significant decrease in heart rate [ （73. ± 8.5） times/min vs. （56.2±11. 2） times/mini and mean arterial pressure [MAP, （81.2±10.8） mmHg vs. （50.2±10.4） mmHg, P〈0.05 both] in BHUT positive subjects. There were 21 HUTSI positive cases （53.9%） among the other 39 VVS pa- tients, and two cases （5.3%） among the 38 subjects of normal control group. From supine to HUTSI positive, there were significant decrease in heart rate [ （65.2 ± 7.5） times/min vs. （52.9 ± 10.5） times/mini and MAP [ （78. 3±10.7） mmHg vs. （48.8±11.2） mmHg, P〈0.05 both] in HUTSI positive subjects. Duration from tilt started to positive reaction occurred in HUTSI positive group was significantly shorter than that of BHUT positive group [ （10.8±9.3） min vs. （21.1±11.5） rain, P〈0.05]. All subjects can tolerate the test and only two cases in VVS group and one case in normal control group occurred headache and face red. Conclusion.. Head-up tilt test with sublingual isosorbide dinitrate is a practical and easy-to-perform method with high sensitivity, specificity and few side effects for diagnosis of vasovagal syncope.

关 键 词：晕厥 血管迷走神经性 异山梨酯 硝酸 倾斜台试验 

分 类 号：R741.041[医药卫生—神经病学与精神病学]