目的探讨性别、年龄、基础心率、基础收缩压及基础舒张压对直立倾斜试验阳性反应发生时间的影响。方法选择2007年1月~2017年4月因晕厥在泰达国际心血管病医院就诊且直立倾斜试验检查阳性患者761例,分为基础试验阳性者141例与激发试验阳...目的探讨性别、年龄、基础心率、基础收缩压及基础舒张压对直立倾斜试验阳性反应发生时间的影响。方法选择2007年1月~2017年4月因晕厥在泰达国际心血管病医院就诊且直立倾斜试验检查阳性患者761例,分为基础试验阳性者141例与激发试验阳性者620例,分析2种试验的阳性反应发生时间与性别、年龄等因素的相关性。结果在基础试验中,与年龄≤30岁患者相比,年龄≥60岁患者阳性反应发生时间明显延长[(26.48±7.70)min vs(19.50±9.66)min,P<0.05];与男性比较,女性阳性反应时间明显延长,差异有统计学意义[(25.12±9.94)min vs(21.32±9.54)min,P=0.023];男性患者阳性反应发生时间随年龄增大呈逐渐延长的趋势,与年龄≤30岁、31~59岁男性患者相比,年龄≥60岁男性患者阳性反应发生时间明显延长,差异有统计学意义(P<0.01);而随年龄的增长,女性患者阳性反应发生时间先延长后缩短,与年龄≤30岁、≥60岁女性患者比较,31~59岁女性患者阳性反应发生时间有所延长,但三者比较无统计学差异(P>0.05)。在激发试验中,与女性比较,男性阳性反应发生时间明显延长,差异有统计学意义[7(5,10)min vs 6(5,9)min,P=0.007]。结论在基础试验阳性患者中,女性阳性反应发生时间较男性延迟,男性随着年龄的增长,阳性反应发生时间逐渐延迟。而在激发试验阳性患者中,仅发现男性患者出现阳性反应的时间比女性延迟,与其他因素无关。展开更多
Objective: To evaluate the serious response during tilt-table test (TTT) and its prophylactic management. Method: Seventy-six elderly patients were tested at a tilt angle of 70 degrees for a maximum of 45 min and then...Objective: To evaluate the serious response during tilt-table test (TTT) and its prophylactic management. Method: Seventy-six elderly patients were tested at a tilt angle of 70 degrees for a maximum of 45 min and then subjected to isoprotere- nol-provocative tilt testing. ECG and blood pressure were monitored during the test and patients were kept at normal saline con- dition through a peripheral intravenous duct. Results: Fifty-one of 76 patients were defined as positive including 23 having serious response; 6 of the 23 patients had arteriosclerosis involving internal carotid arteries and 7 cases had bradycardia, two of which were associated with II°-I A-V block and the others with chronic atrial fibrillation. The serious response consisted of cardiac arrest for more than 5 s (6 cases), or serious bradycardia for more than 1 min (7 cases) or serious hypotension for more than 1 min (10 cases). Those with serious response were managed by returning to supine position, thus driving up legs and intravenous atropine, CPR (2 cases with cardiac arrest) and needing oxygen supplementation (11 cases). Only 2 hypotension patients recovered gradually by 10 min after emergency management, while others recovered rapidly with no complications. Conclusion: Although non-invasive, TTT may result in serious response, especially in elderly. Therefore proper patient selection, control of isoproterenol infusion and close observation of vital signs are decisive for a safe consequence.展开更多
文摘目的探讨性别、年龄、基础心率、基础收缩压及基础舒张压对直立倾斜试验阳性反应发生时间的影响。方法选择2007年1月~2017年4月因晕厥在泰达国际心血管病医院就诊且直立倾斜试验检查阳性患者761例,分为基础试验阳性者141例与激发试验阳性者620例,分析2种试验的阳性反应发生时间与性别、年龄等因素的相关性。结果在基础试验中,与年龄≤30岁患者相比,年龄≥60岁患者阳性反应发生时间明显延长[(26.48±7.70)min vs(19.50±9.66)min,P<0.05];与男性比较,女性阳性反应时间明显延长,差异有统计学意义[(25.12±9.94)min vs(21.32±9.54)min,P=0.023];男性患者阳性反应发生时间随年龄增大呈逐渐延长的趋势,与年龄≤30岁、31~59岁男性患者相比,年龄≥60岁男性患者阳性反应发生时间明显延长,差异有统计学意义(P<0.01);而随年龄的增长,女性患者阳性反应发生时间先延长后缩短,与年龄≤30岁、≥60岁女性患者比较,31~59岁女性患者阳性反应发生时间有所延长,但三者比较无统计学差异(P>0.05)。在激发试验中,与女性比较,男性阳性反应发生时间明显延长,差异有统计学意义[7(5,10)min vs 6(5,9)min,P=0.007]。结论在基础试验阳性患者中,女性阳性反应发生时间较男性延迟,男性随着年龄的增长,阳性反应发生时间逐渐延迟。而在激发试验阳性患者中,仅发现男性患者出现阳性反应的时间比女性延迟,与其他因素无关。
文摘Objective: To evaluate the serious response during tilt-table test (TTT) and its prophylactic management. Method: Seventy-six elderly patients were tested at a tilt angle of 70 degrees for a maximum of 45 min and then subjected to isoprotere- nol-provocative tilt testing. ECG and blood pressure were monitored during the test and patients were kept at normal saline con- dition through a peripheral intravenous duct. Results: Fifty-one of 76 patients were defined as positive including 23 having serious response; 6 of the 23 patients had arteriosclerosis involving internal carotid arteries and 7 cases had bradycardia, two of which were associated with II°-I A-V block and the others with chronic atrial fibrillation. The serious response consisted of cardiac arrest for more than 5 s (6 cases), or serious bradycardia for more than 1 min (7 cases) or serious hypotension for more than 1 min (10 cases). Those with serious response were managed by returning to supine position, thus driving up legs and intravenous atropine, CPR (2 cases with cardiac arrest) and needing oxygen supplementation (11 cases). Only 2 hypotension patients recovered gradually by 10 min after emergency management, while others recovered rapidly with no complications. Conclusion: Although non-invasive, TTT may result in serious response, especially in elderly. Therefore proper patient selection, control of isoproterenol infusion and close observation of vital signs are decisive for a safe consequence.
