血管迷走性晕厥伴焦虑患者经颅多普勒联合直立倾斜试验的特点分析  

Analysis of characteristics of transcranial Doppler combined with upright tilt test in patients with vasovagal syncope and anxiety

作　　者：谢薇 林涛[2] XIE Wei;LIN Tao(Department of Neurology,Yibin Second People's Hospital,Yibin 644000,China;Pain Department,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital(Affiliated Hospital of University of Electronic Science and Technology of China),Chengdu 610072,China)

机构地区：[1]四川省宜宾市第二人民医院神经内科,四川宜宾644000 [2]四川省医学科学院·四川省人民医院(电子科技大学附属医院)疼痛科,四川成都610072

出　　处：《实用医院临床杂志》2024年第5期153-156,共4页Practical Journal of Clinical Medicine

基　　金：四川省科技厅重点研发项目(编号:2022YFS0278)。

摘　　要：目的分析经血管迷走性晕厥(vasovagol syncope,VVS)伴焦虑患者经颅多普勒联合直立位倾斜实验的特点。方法选择我院2021年7月至2023年7月诊治的患者90例,根据症状不同分为VVS有焦虑组、VVS无焦虑组、焦虑无VVS组,同期健康体检者为健康对照组,每组各30例。收集一般资料、直立倾斜试验(head-up tilt test,HUTT)血流动力学、经颅多普勒(transcranial doppler,TCD)脑血流进行对比,VVS伴焦虑患者治疗前后TCD与复发之间的关系。结果4组间比较,HUTT直立位相比平卧,VVS伴焦虑组心室率增加最少,TCD血流速度在收缩期和舒张期末下降明显,搏动指数和阻力指数增加最多(P<0.01);VVS伴焦虑组治疗后TCD无改善复发率高(P<0.05)。结论VVS伴焦虑患者有自主神经功能异常存在,治疗后TCD预测再发率有临床价值。Objective To analyze the characteristics of transcranial Doppler combined with upright tilt test in patients with vasovagal syncope(VVS)accompanied by anxiety.Methods Ninety patients who were diagnosed and treated in our hospital from July 2021 to July 2023 were selected.The patients were divided into a VVS anxiety group,a VVS anxiety-free group,and an anxiety VVS-free group based on different symptoms,30 in each group.During the same period,30 healthy individuals underwent physical examinations were taken as a control group.The general information was collected.The head up tilt test(HUTT),hemodynamics andtranscranial Doppler(TCD)cerebral blood flow were compared.The relationship between TCD and recurrence in VVS patients with anxiety before and after treatment was analyzed.Results Among the four groups,the VVS anxiety group showed the least increase in ventricular rate,TCD blood flow velocity was decreased significantly during systole and diastole and the pulsatile index and resistance index were most increased when HUTT upright position compared to supine position(P<0.01).After treatment,the VVS anxiety group had a high recurrence rate without TCD improvement(P<0.05).Conclusions Patients with VVS accompanied by anxiety have abnormal autonomic nervous system function.The use of TCD for prediction of recurrence rate after treatment has a clinical value.

关 键 词：血管迷走性晕厥 焦虑 经颅多普勒 特点 

分 类 号：R743[医药卫生—神经病学与精神病学]