血管迷走性晕厥的诊断治疗手段及评价

Methods and Evaluation for Diagnosis andManagement of Vasovagal Syncope

血管迷走性晕厥(VVS)的诊断主要依靠详细的病史询问和体格检查,并排除其他类型的晕厥。目前认为直立倾斜试验(HUT)是诊断VVS的“金标准”。HUT检查阴性的部分所谓不明原因晕厥的VVS病人可通过植入性心电记录仪进行诊断。偶发VVS不需要特别处理,复发性VVS及部分特殊人群才需要进一步的诊治。目前VVS尚无有效的根治方法,其治疗以预防发作为主,包括患者教育、一般治疗、药物治疗(β-受体阻滞剂、盐皮质激素、抗胆碱能药物、选择性5-羟色胺重吸收抑制剂、α-受体激动剂)及起搏器治疗等几个方面。

The diagnosis of vasovagal syncope （VVS） depends mainly on detailed medical history and excludes other causes of syncope. At present,head up tilt test is the gold standard for the diagnosis of VVS. Insertable loop recorder （ILR） may be needed in the patients with so-called syncope of unknown origin who are negative for HUT, There is no need for the treatment of seldom episodes. Further treatments are needed for reccurrence of VVS and special patients. Presently,there is no methods that can cure VVS. The main purposes for the management of VVS are prevention of its occurrence, including education, general management, drug therapy （beta-blockers ,fludrocortisone, anticholinergic drugs,selective serotonin reuptake inhibitors and α-angonists） and cardiac pacing.