心率减速力及心率变异性对中老年血管迷走性晕厥患者的诊断价值  

Value of deceleration capacity and heart rate variability to diagnosis of vasovagal syncope in middle-aged and elderly people

作　　者：陈旭凤[1] 徐春芳[1] 黄芬[1] 邓小艳[1] 樊静静[1] 林凡[1] 杨晓云[1] CHEN Xu-feng;XU Chun-fang;HUANG Fen;DENG Xiao-yan;FAN Jing-jing;LIN Fan;YANG Xiao-yun(Department of Electrocardiogram,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science ＆ Technology,Wuhan 430030,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属同济医院心功能室,湖北武汉430030

出　　处：《心脏杂志》2018年第5期549-552,共4页Chinese Heart Journal

摘　　要：目的评价心率减速力(deceleration capacity,DC)和心率变异性(heart rate variability,HRV)对中老年血管迷走性晕厥(vasovagal syncope,VVS)患者的诊断价值。方法对57例不明原因晕厥的中老年患者进行直立倾斜试验(HUTT)及动态心电图监测,根据结果将研究对象分为HUTT阳性组(25例)和HUTT阴性组(32例)。分析两组DC和HRV各指标的差异。绘制ROC曲线,分析DC和HRV对中老年VVS患者的诊断价值。结果 HUTT阳性组DC和HRV各指标均高于阴性组,其中DC、SDNNi、r MSSD、LF显著增高,差异有统计学意义(P <0. 05)。ROC曲线分析结果显示,DC和LF对VVS的检出存在预测价值,最佳的临界值分别为6. 6 ms、340 Hz。结论中老年VVS患者在无症状期间自主神经功能紊乱。DC和LF适用于临床筛查中老年VVS患者。AIM To investigate diagnostic values of deceleration capacity （DC） and heart rate variability （HRV） in vasovagal syncope （WS） middle-aged and elderly patients. METHODS Fifty-seven patients with unexplained syncope underwent head-up tilt test （HUTT） and Holter monitoring. According to HUTT results, they were divided into two groups： HUTT positive （25 cases） and HUTT negative （32 cases）. The DC and HRV of the two groups were analyzed. The receiver operating characteristic （ROC） curve was used to explore the diagnostic values of DC and HRV. RESULTS The DC and HRV in the HUTT positive group were higher than those in the HUTr negative group. There were significant differences in DC, SDNNi, rMSSD and LF. ROC analysis demonstrated that DC and LF could be considered as indicators for diagnosing WS. The best cut-off value of DC and LF were 6.6 ms and 340Hz, respectively. CONCLUSION The dysfunction of the autonomic nervous system may be seen in the VVS middle-aged and elderly populations during an asymptomatic period. DC and LF are suitable for clinical screening in VVS in the middle-aged and elderly populations.

关 键 词：血管迷走性晕厥 心率减速力 心率变异性 中老年人 

分 类 号：R364.1[医药卫生—病理学]