血管迷走性晕厥患者射频消融术后倾斜试验转阴的因素分析  

Analysis of factors influencing the negative head-up tilt test results in patients with vasovagal syncope following radiofrequency ablation

作　　者：陈斌 段一超 王璟 王瑞 郑鑫 薛仙军 崔洺植 杨叶 张博 王媛 许戈 许岭平 侯军龙 Chen Bin;Duan Yichao;Wang Jing;Wang Rui;Zheng Xin;Xue Xianjun;Cui Mingzhi;Yang Ye;Zhang Bo;Wang Yuan;Xu Ge;Xu Lingping;Hou Junlong(Department of Cardiology,Syncope Center,Xianyang Central Hospital,Xianyang 712000,China)

机构地区：[1]咸阳市中心医院心血管内科晕厥中心,咸阳712000

出　　处：《中华心律失常学杂志》2025年第1期45-49,共5页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的探讨血管迷走性晕厥(VVS)患者接受射频消融治疗术后直立倾斜试验(HUTT)转阴的相关影响因素。方法本研究为单中心回顾性队列研究。纳入2018年1月至2024年7月在咸阳市中心医院接受射频消融治疗的VVS患者107例,根据HUTT结果将患者分为转阴组和未转阴组。通过比较两组患者的基线资料,筛选出具有统计学意义的变量,并进行单因素及多因素Logistic回归分析,评估与HUTT转阴相关的独立危险因素。基于多因素分析结果,使用受试者工作特征(ROC)曲线评估模型的预测性能。结果纳入107例患者,其中男42例,女65例,年龄(49.7±15.3)岁,年龄范围为13~75岁。转阴组71例,未转阴组36例。单因素Logistic回归分析显示,年龄、收缩压下降幅度、舒张压下降幅度、最低收缩压和最低舒张压均与HUTT转阴显著相关(P<0.05)。多因素分析结果表明,舒张压下降幅度是HUTT转阴的独立危险因素(OR=0.665,95%CI 0.446~0.993,P=0.046),而最低收缩压差异无统计学意义(P=0.058)。ROC曲线分析显示,曲线下面积(AUC)为0.955(95%CI 0.916~0.995,P<0.001),表明模型具有良好的预测效能。不同HUTT分型在转阴率上的差异无统计学意义(P=0.703)。结论舒张压下降幅度显著影响HUTT的转阴结果,而最低收缩压也可能在HUTT中发挥重要作用。Objective To investigate the factors influencing head-up tilt test(HUTT)reversion in patients with vasovagal syncope undergoing radiofrequency ablation(RFA).influences HUTT reversion outcomes,and minimum SBP may also play a crucial role.Methods This was a restrospective cohort study.A total of 107 patients with vasovagal syncope undergoing radiofrequency ablation were selected from January 2018 to July 2024.Patients were divided into two groups based on their HUTT outcomes:the reversion group and the non-reversion group.Baseline characteristics were compared between the two groups,and variables with statistical significance were identified.Univariate and multivariate Logistic regression analyses were performed to evaluate the independent risk factors associated with HUTT reversion.A predictive model was developed based on multivariate analysis results,and the model's predictive performance was assessed using the receiver operating characteristic(ROC)curves.ResultsA total of 107 patients were included,including 42 males and 65 females,with an average age of(497±15.3)years,ranging from 13 to 75 years.There were 71 cases in the reversion group and 36 cases in the non-reversion group.Univariate Logistic regression analysis identified age,systolic blood pressure(SBP)drop,diastolic blood pressure(DBP)drop,minimum SBP,and minimum DBP were significantly associated with HUTT reversion(P<0.05).Multivariate analysis revealed that DBP drop was an independent predictor of HUTT reversion(OR=0.665,95%CI 0.446-0.993,P=0.046).Minimum SBP showed a trend toward significance(P=0.058).The ROC curve analysis demonstrated excellent predictive performance,with an area under the curve(AUC)of 0.955(95%CI 0.916-0.995,P<0.001).Conclusion DBP drop significantly influences HUTT reversion outcomes and minimum SBP may also play a crucial role.

关 键 词：晕厥 血管迷走神经性 射频消融 直立倾斜试验 危险因素 受试者操作曲线 

分 类 号：R541.4[医药卫生—心血管疾病] R54[医药卫生—内科学]