摘要
目的探讨血管迷走性晕厥(VVS)患者直立倾斜试验(HUTT)反应类型发生转变的机制。方法2003-06～2008-04在我院晕厥专科门诊就诊或住院的以不明原因晕厥或晕厥先兆为主诉的患者50例,年龄7～53岁[平均(14.82±8.55)岁],男性15例,女性35例,HUTT检查为阳性,诊断为VVS。经健康教育与药物干预治疗后,随诊并追踪复查HUTT。HUTT采用基础直立倾斜试验(BHUT)及舌下含化硝酸甘油直立倾斜试验(SNHUT),比较初诊检查与重复检查的HUTT反应类型。结果第一次HUTT复查50例中有5例(10%)HUTT反应类型发生改变,第二次HUTT复查10例中有2例(20%)HUTT反应类型发生改变。HUTT反应类型发生转变见于心脏抑制型转变为混合型、血管抑制型转变为混合型、混合型转变为心脏抑制型、混合型转变为血管抑制型。结论VVS患者随访过程中HUTT反应类型可发生转变,HUTT反应类型转变的机制受患者自主神经功能状态、干预治疗方法及患者的耐受性等多因素影响。
Objective To explore the mechanism of reaction type changes of head - up tilt test （ HUTT） in the patients with vasovagal syncope （ VVS ）. Methods 50 patients with VVS of positive responses in first HUTT examination who came from syncope department and the hospitalization of the Second Xiangya Hospital of Central South University from June 2003 to April 2008 were included in the study. A follow - up and repeated HUTT were conducted. HUTT included basic head - up tilt test （ BHUT ） and sublingual nitroglycerin head - up tilt test （ SNHUT ）. The results of the repeated HUTT were compared with result of the first HUTT. Results 5 of 50 （ 10% ） patients ＇ reaction type of HUTT changed in the first repeated HUTT and 2 of 10 （ 20% ） patients ＇ reaction type of HUTT changed in the second repeated HUTT. Reaction type changes of HUTT included four types ： （1）The HUTT result changed from cardio - inhibitory response to mixed response. （2）The HUTT result changed from vaso - depressor response to mixed response. （3）The HUTT result changed from mixed response to cardio - inhibitory response. （4）The HUTT result changed from mixed response to vaso - depressor response. Conclusions The HUTT result of patients with VVS change during follow - up. The mechanism of reaction type changes of HUTT is affected by many factors such as the autonomic nerve＇s state of VVS, preventive or therapeutical measures, and the toleration of patients and so on.
出处
《中国急救医学》
CAS
CSCD
北大核心
2008年第12期1081-1083,共3页
Chinese Journal of Critical Care Medicine
基金
湖南省科技厅资助项目(No.06SK3036,No.2008SK3111)
“十五”国家科技攻关计划项目(No.2004BA720A10)
湖南省研究生创新基金项目(No.2340-74335000016)
