摘要
目的观察发作频率不同的血管迷走性晕厥患者的预后。方法对因晕厥就诊的门诊患者进行体检，筛查出159例15～59岁的患者，根据在首诊之前5年内晕厥发作次数分为低频组（95例）和高频组（64例），同时根据治疗方法的不同将患者划分为3类治疗级别：未治疗亚组、物理治疗亚组和综合治疗亚组，并对人群进行为期24个月的随访，观察患者发作晕厥的情况。结果高频组晕厥前兆的发生率明显高于低频组[40．6％（26／64）比11．6％（11／95），P〈0．01]；低频组晕厥总体好转率明显高于高频组（P〈0．01），低频组患者物理治疗亚组及综合治疗亚组晕厥好转率[分别为81．8％（27／33）和82．2％（37／45）]均明显高于未治疗亚组[47．1％（8／17），P均〈0．05]；高频组综合治疗亚组好转率明显高于物理治疗亚组[62．2％（28／45）比31．6％（6／19），P〈0．05]。结论针对晕厥发作次数较少的患者，物理治疗可以明显降低晕厥的复发率。针对晕厥发作次数多的患者，应该采用物理联合药物的治疗方案。
Objective To analyze the impact of attack frequency as well as therapy strategies on outcome of patients with vasovagal syncope （VVS）. Methods A total of 159 patients （aged from 15 -59 years old） with VVS were included in this study. Patients were divided into low frequency （ 〈 3） group （n =95） and high （I〉3） frequency group （n =64） according to the attack frequency in the past 5 years at the primary survey. Patients received one of the three therapies： no treatment, physical therapy, and comprehensive treatment. All cases were followed up with telephone or outpatient visit for 24 months. Results Incidence of syncope was significantly higher in the high frequency group and in the low frequency group [40. 6% （26/64） vs. 11.6% （ 11/95）, P 〈0. 01 ]. The overall improvement rate was significantly higher in the low frequency group than that of high frequency group （P 〈 0.01 ）. Improvement rate was significantly higher in the physical therapy subgroup and the comprehensive treatment subgroup than no treatment subgroup for patients with low attack frequency [ 81.8% （ 27/33 ） vs. 47.1% （ 8/17 ）, P 〈 0. 05 ; 82. 2% （37/45） vs. 47. 1% （8/17）, P 〈 0. 05 ], and in comprehensive treatment subgroup than in physical therapy subgroups observed between and [ 62. 2% （ 28/45 ） vs. 31.6% （ 6/19 ）, P 〈 0. 05 ] for patients with high attack frequency. Conclusion Outcome is related to previous attack frequency for patients with VVS, physical therapy is effective for reducing the recurrence rate of syncope in VVS patients with low attack frequency while physical therapy combined with pharmacotherapy should be applied for VVS patients with high attack frequency to improve outcome.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2012年第12期1016-1019,共4页
Chinese Journal of Cardiology
基金
广东省2009科技计划项目（20098030801279）
广东省科技计划重点项目（2010803150015）
