不同年龄、性别、直立倾斜试验结果患者试验期间心率差值比较及结果阳性的预测价值研究  

Comparison of heart rate differences among patients of different ages,genders,and HUTT results and the predictive value for positive outcomes

作　　者：武梦依 韩鹏宇 郑朝阳 李杰[1,2] 姚耿圳 WU Meng-yi;HAN Peng-yu;ZHENG Zhao-yang;LI Jie;YAO Gengzhen(The Second Affiliated Hospial of Guangzhou University of Chinese Medicine,Guangzhou 510120,China;Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二附属医院心血管内科,广东广州510120 [2]广东省中医院心血管内科,广东广州510120

出　　处：《中国实用内科杂志》2025年第2期121-126,共6页Chinese Journal of Practical Internal Medicine

基　　金：国家中医药管理局重点研究室建设项目(国中医药科技发[2012]27号);第七批全国老中医药专家学术经验继承项目(国中医药办人教函[2022]76号);广东省中医药局项目(20215004);基于AMPK/mTOR介导的自噬-焦亡途径探讨调脾护心方抗动脉粥样硬化机制,2023年度市校(院)企联合资助专题(2023A03J0230);广东省中医院中医学术流派传承工作室建设项目(中医二院[2013]233号);中医药人才培养重点学科建设项目-中医心病学。

摘　　要：目的探讨非发作期的心率差值对血管迷走性晕厥的预测价值。方法分析广东省中医院2013年至2021年333例直立倾斜试验患者的基本资料,并在年龄组、性别、直立倾斜试验(HUTT)结果与心率差值进行统计分析。结果基础试验中,心率差值随年龄增加逐渐减小;阳性患者差值高于阴性患者;心脏抑制型差值高于其他分型。药物试验中,21~40岁组心率差值高于≤20岁组;阳性患者各时间点差值均高于阴性;第9 min男性差值高于女性。基础试验3 min、9 min、15 min差值大于10、6和10时,阳性概率为62.9%、62.2%、60.3%;药物试验1 min、3 min、5 min、9 min差值大于13、25、28、26时,阳性概率为50.5%、58.2%、60.7%、63.4%。结论不同年龄、性别以及HUTT结果与心率差值的比较具有统计学意义,心率差值对于HUTT阳性结果具有临床预测价值。Objective To investigate the predictive value of heart rate differences during non-episodic periods for vasovagal syncope.Methods The data from 333 cases of patients undergoing head-up tilt test(HUTT)in Guangdong Hospital of Traditional Chinese Medicinefrom 2013 to 2021were analyzed.Statistical analysis of heart rate differences was performed across age groups,genders,and HUTT results.Results In the basic test,heart rate diferences decreased with increasing age;positive patients had higher differences than negative patients;cardiac inhibitory type showed the highest differences among all subtypes.In the drug-induced test,the 21-40 age group had higher heart rate differences than the≤20 group;positive patients had higher dfferences at all time points compared to negative patients;at the 9th minute,male patients exhibited higher differences than females.The predictive probabilities for positive results were 62.9%,62.2%,and 60.3% when heart rate differences in the basic test exceeded 10,6,and 10 at 3,9,and 15 minutes,respectively.In the druginduced test,probabilities for positive results were 50.5%,58.2%,60.7% and 63.4% when differences exceeded 13,25,28,and 26 at 1,3,5 and 9 minutes,respectively.Conclusion Comparisons of heart rate differences in different ages,genders,and HUTT results are of statistical significance,and heart rate differences demonstrate clinical predictive value for HUTT positive outcomes.

关 键 词：血管迷走性晕厥 直立倾斜试验 心率 心率差值 

分 类 号：R543[医药卫生—心血管疾病]