成人体位性心动过速综合征82例临床特征  

Analysis of clinical characteristics in 82 adults patients with postural orthostatic tachycardia syndrome

作　　者：郑华[1] 李洁[1] 王海燕[1] 李辉[1] 周辉[1] 原标[2] 田宇[2] 

机构地区：[1]首都医科大学附属北京同仁医院心血管中心,北京100730 [2]首都医科大学附属北京朝阳医院血管外科,北京100050

出　　处：《首都医科大学学报》2016年第3期400-404,共5页Journal of Capital Medical University

摘　　要：目的探讨成人体位性心动过速综合征(postural orthostatic tachycardia syndrome,POTS)的临床特征。方法分析经直立倾斜试验(head-up tilt test,HUTT)诊断为POTS的患者82例,其平均年龄(38.7±12.24)岁;以直立倾斜试验阴性排除POTS的31名受试者为对照组,平均年龄(39.22±10.98)岁。对POTS患者详细询问病史并进行体格检查,分析POTS患者发病的临床特征。结果与对照组相比,POTS组患者在性别比例、年龄、平卧位心率和血压方面差异无统计学意义。POTS患者以晕厥多见(63例,76.8%),症状发作频繁34.14%(发作>10次)。晕厥发作和非晕厥患者(19例,23.2%)间性别、年龄比较差异无统计学意义。大多数POTS患者发作前有诱因,诱因多为体位变化、情绪紧张、劳累、运动、天气闷热等。常见的临床表现为晕厥、头晕、心悸、胸闷、黑矇、大汗、面色苍白、乏力。在直立倾斜试验中,POTS患者心率逐渐增加,平均最大增加值为(45.05±11.06)次/min。结论 POTS在各年龄阶段均可发生,晕厥发生率较高。诱因以情绪紧张、劳累、运动、天气闷热多见。Objective To analyze pathological features of adults with postural orthostatic tachycardia syndrome（ POTS）. Methods Eighty-two adults aged（ 38. 7 ± 12. 24） years who were diagnosed with POTS by head-up tilt test in clinics were selected to constitute the POTS group. Thirty-one adults aged（ 39. 22 ± 10. 98） years with negative the head-up tilt test who are excluded POTS served to consititute the control group. History collection and physical examination were done for all POTS patients. Clinical characteristics of POTS adults were summarized. Results There were no statistical differences between POTS and the control group in age,sex radio,supine heart rate and supine blood pressure. About 76. 8% POTS took syncope as major symptoms. About 34. 14% of them experienced frequent episodes（ 10 times）. 68 patients had syncope and 19 patients did not have syncope. There were no statistical differences in sex and age between two groups. Most of them have causes before the onset of POTS. The main causes of POTS include postural changes,mental stress,fatigue,exercise,etc. The main symptoms include syncope,dizziness,palpitations,chest tightness,amaurosis,sweet,pale complexion,fatigue. During the head-up tilt test,the HR of patients with POTS increased gradually,and the average maximal HR increase was（ 45. 05 ± 11. 06） beats per minute. Conclusion The patients with POTS are usually in all age groups and have a high incidence of syncope. The common symptoms of POST include syncope,dizziness,palpitations,chest tightness,sweet,pale complexion,fatigue. In the head-up tilt test the HR significantly increases in ten minutes and HR increases ≥40bpm.

关 键 词：体位性心动过速综合征 直立倾斜试验 心率 

分 类 号：R441.4[医药卫生—诊断学]