倾斜试验药物激发顺序对血管迷走性晕厥的诊断价值研究  

Research on the diagnostic value of tilt testing drug excitation sequence for vasovagal syncope

作　　者：孙汝平[1] 牛吉攀 邱妍妍[1] 吴蕊[1] 徐金义[1] 

机构地区：[1]河南省人民医院,河南郑州450003 [2]河南省直第二医院,河南郑州450000

出　　处：《中国卫生检验杂志》2015年第12期1959-1961,1964,共4页Chinese Journal of Health Laboratory Technology

基　　金：河南省科学技术厅资助项目(122102310485)

摘　　要：目的探讨直立倾斜试验药物激发顺序在诊断血管迷走性晕厥中的作用。方法回顾性分析本院行直立倾斜试验600例晕厥患者,根据药物激发顺序随机分为两组,硝酸甘油组与异丙肾上腺素组各300例,两组均采用倾斜三步试验法。结果 1异丙肾上腺素组第二步、第三步试验阳性反应时心率及收缩压下降程度优于硝酸甘油组(P<0.05);两组第二步、第三步阳性反应时心率、收缩压及舒张压下降程度均优于对应组第一步(P<0.05),但两组第二步、第三步之间差异无统计学意义(P>0.05)。2两组各阶段血流动力学类型差异无统计学意义(P>0.05)。3异丙肾上腺素组第二步及第三步试验的阳性率高于硝酸甘油组(P<0.05)。结论单种药物刺激激发试验较基础倾斜试验阳性率高,而两种药物联合激发试验阳性率又高于单种药物激发试验,且异丙肾上腺素组阳性率要高于硝酸甘油组。Objective To explore the function of tilt table testing drug excitation sequence in the diagnosis of vasovagal synco- pe. Methods To retrospectively analyze the 600 syncope patients undergoing tilt table testing, who were randomly divided into isoprenaline group and nitroglycerin group according to the drug excitation sequence, 300 cases for each group. Two groups both adopted three - stage tilt table testing method. Results The level of decline of heart rate and systolic ＇blood pressure during the positive reaction of the second and third step in isoprenaline group was better than that in nitroglycerin group （P 〈0. 05） ; the level of decline of heart rate, systolic blood pressure and diastolic blood pressure of two groups of the first and second step was both better than that in the first step of the control group（P 〈0.05）, but there was no statistical significance on the difference of two groups on the first step and second step（P 〉 0.05）. There was no statistical significance on the differences in two types of hemodynamic （ P 〉 0.05 ）. The positive rate of the first and second step in isoprenaline groups was higher than that in the nitro- glycerin group（P 〈0. 05）. Conclusion The positive rate of single drug stimulation test is higher than that of the baseline tilt table test. The positive rate of the two drugs combined for stimulation tests is higher .than that of the single drug stimulation test and the positive rate of isoprenaline group is higher than that of the nitroglycerin group.

关 键 词：倾斜试验三步法 药物激发试验 血管迷走性晕厥 血流动力学 

分 类 号：R540.4[医药卫生—心血管疾病]