倾斜试验及自主神经功能测定在诊断不明原因晕厥中的意义  

The significance of tilt tabl table test and autcmatic nervous function in the diagnosis of the undnown syncope

作　　者：徐伟民[1] 毛旭东[1] 陆凌[1] 周薇[1] 

机构地区：[1]上海市徐汇区中心医院,200003

出　　处：《浙江临床医学》2001年第7期473-474,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 联合直立倾斜试验(TTT)、心率变异度 (HRV)、压力反射敏感性 (BRS)方法对血管迷走性晕厥的诊断作一更精确的评价。方法 22例不明原因晕厥病人和20例正常对照组分别予TTT、HRV、BRS30:15比值检测并进行统计分析。结果(1)22例不明原因晕厥TTT阳性14例 ,总阳性率63.6%。(2)HRV时域变化中 ,阳性组和对照组相比仅示RMSSD有显著差异 (P<0.05)。(3)BRS30:15比值在阳性组、阴性组、对照组中分别为0.95±0.037、0.97±0.023、1.02±0.083,其阳性组与对照组之间存在显著差异 (P<0.01)。结论TTT不失为检测不明原因晕厥的一种重要方法。HRV时域法测定提示RMSSD在阳性组和对照组之间存在显著差异 ,与频域法高频段相关。BRS30:15比值在TTT阳性组中均小于1,提示血管迷走性晕厥者压力反射敏感性低下 ,综合三方面结论 。Objective To discuss the significances of tilt table test(TTT),heart rate variability(HRV)and baroreflection sensitivity (BRS) in the diagnosis of the unknown syncope. Methods Tests were conducted using TTT, HRV and BRS with a 30:15 rate respectively in 22 cases of unknown syncope and 20 healthy controls. Results (1)Of the 22 cases with unknown syncope, 14 (63.6%) showed positive results in TTT.(2)In the HRV time-domain change, a significant difference in RMSSD was found between the positive group and control group (p<0.05).(3)The BRS 30:15 rates in the positive, negative, and control group were found to be 0.95±0.037,0.97±0.023 and 1.02±0.083 respectively, and a significant difference was detected between the positive group and the control group(p<0.01). Conclusion TTT had proved to be a major method in diagnosing unknown syncope. Our findings revealed unknown syncope was relevant to the action of vagal nerve.The combination of TTT with HRV, BRSl would help to make a correct diagnosis of unknown syncope.

关 键 词：直立倾斜试验 心率变异度 压力反射敏感性 晕厥 VVS 

分 类 号：R544.2[医药卫生—心血管疾病]