年龄和性别对直立倾斜试验诊断血管迷走性晕厥结果的影响  

Effect of Age and Gender on Head-up Tilt Test for Diagnosing the Patients With Suspected Vasovagal Syncope

作　　者：姜雪[1] 刘悦[2] 刘俊[3] 阿米娜·艾海提 王超[1] 方丕华[3] 黄建凤[2] 

机构地区：[1]北京协和医学院中国医学科学院国家心血管病中心阜外心血管病医院群体遗传研究室,北京市100037 [2]北京协和医学院中国医学科学院国家心血管病中心阜外心血管病医院功能检测中心,北京市100037 [3]北京协和医学院中国医学科学院国家心血管病中心阜外心血管病医院心律失常诊治中心,北京市100037 [4]新疆自治区人民医院心电学科

出　　处：《中国循环杂志》2014年第9期706-709,共4页Chinese Circulation Journal

基　　金：国家“十二五”科技支撑计划资助项目(2011BAI09B03)

摘　　要：目的：探讨年龄和性别对疑似血管迷走性晕厥（VVS）患者进行直立倾斜试验（HUTT）诊断结果的影响。方法：收集2008-08至2012-12在阜外心血管病医院进行HUTT检查的患者共1 223例,其中男性549例。患者年龄7-79岁,按年龄依次分为≤20岁组、21-40岁组、41-60岁组和〉60岁组。HUTT包括30 min的基础试验阶段和（或）20 min的药物（硝酸甘油）试验阶段。根据阳性患者血压和心电学的变化,VVS分为血管抑制型、心脏抑制型和混合型。结果：HUTT阳性率为51%（624/1 223例）,女性阳性率高于男性（60.1%vs 39.9%,P=0.001）。四组阳性率依次为68.3%、49.1%、48.6%和47.9%。阳性患者中混合型占51.4%（321例）,血管抑制型占28.7%（179例）,心脏抑制型占19.9%（124例）。HUTT阳性类型的分布受年龄因素的影响（男性：χ2=15.65,P=0.016;女性：χ2=18.84,P=0.004）,性别间差异无统计学意义（P〉0.05）。基础试验阶段74.8%的阳性反应出现在试验开始后22.5（17.5-27.5）min,但无年龄性别差异（P〉0.05）;药物试验阶段81.9%的阳性反应出现在试验开始后7.5（5-10）min,女性发生阳性反应的时间比男性提前（7.5 min vs 10 min,P=0.004）,无年龄差异。结论：HUTT诊断VVS的阳性率、阳性分型和发生阳性反应的时间存在年龄和性别差异。Objective： To explore the effect of age and gender on head-up tilt test （HUTT） for diagnosing the patients with suspected vasovagal syncope （VVS）. Methods： A total of 1223 patients who received HUTT in our hospital from 2008-08 to 2012-12 were studied. The patients were from 7 to 79 years of age and divided into 4 groups. Group 1, the patients≤20 years of age, n=145, Group 2, the patients at （21-40） years, n=375, Group 3, the patients at （41-60） years, n=584 and Group 4, the patients〉60 years, n=119. The HUTT comprised a 30 min basic phase and 20 min sublingual nitroglycerin provocation phase. According to ECG and blood pressure changes, the HUTT positive patients included vasodepressor type, cardio-inhibitory type and mixed type. Results： The overall positive rate of HUTT was 51%（624/1223） and the female was higher than male, （60.1%vs 39.9%）, P=0.001. The positive rates in 4 age groups were at 68.3%, 49.1%, 48.6% and 47.9% respectively. In HUTT positive patients, there were 51.4% （321/624） patients with mixed type of VVS, 28.7% （179/624） with vasodepressor type of VVS and 19.9% （124/624） with cardio-inhibitory type of VVS. The positive HUTT reaction was inlfuenced by the age as in male：x2=15.65, P=0.016 and in female：x2=18.84, P=0.004. For basic phase of HUTT, there were 74.8%of positive reactions started at 22.5 （17.5-27.5） min of the test without age difference, P〉0.05;for sublingual nitroglycerin provocation phase of HUTT, there were 81.9%positive reactions started at 7.5 （5-10） min and the female was earlier than male （7.5 vs 10） min, P=0.004. Conclusion： There were age and gender differences for HUTT diagnosing the patients with VVS for their positive rate, type and starting time.

关 键 词：血管迷走性晕厥 直立倾斜试验 年龄 性别 

分 类 号：R54[医药卫生—心血管疾病]