血管迷走性晕厥与自主神经调节的相关性  

Study on the correlation between vasovagal syncope and autonomic nervous regulation

作　　者：徐金义[1] 张强[2] 乔鹏[3] 王文涛[1] 杨蕊珂[2] 吴蕊[1] 邱妍妍[1] 

机构地区：[1]河南省人民医院心功能科,郑州450003 [2]郑州大学第二附属医院心内科,郑州450014 [3]郑州大学基础医学院生理教研室,郑州450000

出　　处：《中国实用神经疾病杂志》2013年第13期37-39,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨三种不同类型血管迷走性晕厥(VVS)患者的心脏自主神经调节功能,探讨其VVS发病的相关性。方法随机选取经直立倾斜试验诊断血管迷走性晕厥患者368例(Ⅰ组)和健康体检者418例(Ⅱ组)的动态心电图结果进行回顾性分析,Ⅰ组患者按试验诊断标准分为血管抑制型(Ⅰa组)211例,混合型(Ⅰb组)125例,心脏抑制型(Ⅰc组)32例。将4组窦性心率震荡中的震荡初始(turbulence onset,TO)、震荡斜率(turbulence slope,TS)和动态心率震荡(turbulence dynamic-ity,TD)值进行比较分析。结果(1)Ⅰ组患者中TO、TS、TD异常发生率高于Ⅱ组;Ⅰa、Ⅰb、Ⅰc组患者中TO、TS、TD异常发生率相比差异无统计学意义(P>0.05),3组数值分别与Ⅱ组相比差异有统计学意义(P<0.05)。(2)Ⅰa、Ⅰb、Ⅰc组患者的TO、TS、TD值相比较,TO值(Ⅰa组>Ⅰb组>Ⅰc组),TS值(Ⅰa组<Ⅰb组<Ⅰc组),组间比较差异无统计学意义(P>0.05)。结论血管迷走性晕厥患者动态心电图显示窦性心率震荡现象异常,同时不同类型的血管迷走性晕厥患者对窦性心律反应一致,从而窦性心率震荡可辅助诊断血管迷走性晕厥。Objective To investigate the correlation between three different vasovagal syncope and autonomic nervous regulation.Methods The 24 hours Holter monitoring results in 368 patients with vasovagal syncope（considered as groupⅠ） and 418 healthy people（considered as groupⅡ） were retrospectively analyzed;GroupⅠcould be divided into vasodepressor type（groupⅠa,211 cases）,mixed type（groupⅠb,125 cases） and cardio inhibitory（groupⅠc,32 cases）;The turbulence onset（TO）,turbulence slope（TS） and turbulenec dynamicity（TD） of sinus heart rate in the above 4 groups were compared.Results The abnormal rate of TO,TS and TD in groupⅠwere higher than that in groupⅡ;The abnormal rate of TO,TS and TD in groupⅠa,groupⅠb and groupⅠc had a significantly statistical difference compare with groupⅡ（P0.05）;The TO value in groupⅠa was higher than that in groupⅠb,and the TO value in groupⅠb was higher than that in groupⅠc;The TS value in groupⅠa was lower than that in groupⅠb,and the TS value in groupⅠb was lower than that in groupⅠc.Conclusion The 24 hours Holter monitoring of patients with vasovagal syncope shows an abnormal TD.Meanwhile,different type patients with vasovagal syncope have consistent heart response,which can help to dianose the vasovagal syncope.

关 键 词：血管迷走性晕厥 心率震荡 自主神经 

分 类 号：R972.4[医药卫生—药品]