平板运动试验对12例运动后血管迷走性晕厥的诊断  

Diagnostic value of treadmill exercise test in 12 patients with postexercise vasovagal syncope

作　　者：朱洁明[1] 吴琳[1] 徐莉[1] 周彬[1] 梁宇恩[1] 钱孝贤[1] 

机构地区：[1]中山大学附属第三医院心内科,广东广州510630

出　　处：《中国心脏起搏与心电生理杂志》2017年第6期529-532,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金面上项目(项目编号:81370447)

摘　　要：目的探讨平板运动试验对运动后血管迷走性晕厥的诊断价值。方法入选2008年9月至2016年9月于本院行平板运动试验(TET)恢复期中诱发先兆晕厥或晕厥患者,运动中无ST段抬高或压低,次日行基础倾斜试验45min,阴性者舌下含服硝酸甘油诱发试验30min。回顾性分析患者临床资料、TET检查结果、疾病分型、晕厥或先兆晕厥的症状。结果 818例受试者行TET,恢复期诱发先兆晕厥共12例,其中男10例,女2例,年龄(34.0±7.8)岁。其中2例为血管抑制型,6例为心脏抑制型,4例为混合型。运动最大心率(180.5±6.7)次/分。运动耐量(13.15±1.66)mets。12例患者运动中均无胸闷、心悸、头晕等不适,无ST-T改变及心律失常,无血压下降。12例受试者行直立倾斜试验均阴性。结论 TET对血管迷走性晕厥有一定诊断价值,发作晕厥患者应该注意运动保护。Objective To explore the diagnostic value of treadmill exercise test（TET）in patients with postexercise vasovagal syncope（VVS）. Methods From Sep 2008 to Sep 2016 in the third affiliated hospital,Sun Yat-sen University,patients with syncope or pre-syncope in TET recovery phase were assessed.All cases had not been found ST-segment elevation or depression.All patients had a routine checkup to exclude organic heart diseases,neurological diseases and other conditions then received head-up tilt test（HUTT）after TET in another day.Heart rate and arterial pressure were monitored throughout both TET and HUTT.Subject characteristics,TET results,disease subtypes,premonitory symptoms of syncope,and incidence of syncope in TET or HUTT were retrospectively analyzed. Results Twelve cases of baseline head-up tilt test（BHUT）and nitroglycerin-stimulated head-up tilt test（NHUT）were all negative.These patients comprised 10 males and 2 female[age（34.0±7.8）years old].The maximal heart rate was（180.5±6.7）bpm.The metabolic equivalents of all cases were（13.15±1.66）mets.Disease subtypes：2 case was vasodepressive type,6 cases were cardioinhibitory type,4 cases were mixed type.The total test time of BHUT was 45 minutes,and the total test time of NHUT was 20 minutes after sublingualing nitroglyscerin. Conclusion TET is of some value in the diagnosis of vasovagal syncope.Attention should be paid to exercise protection in patients with syncope in TET.

关 键 词：心血管病学 血管迷走性晕厥 平板运动试验 直立倾斜试验 

分 类 号：R364.14[医药卫生—病理学]