血压与心率基础值对直立倾斜试验阳性结果的影响

Effects of basic blood pressure and basic heart rate on the head-up tilt test

目的探讨血压与心率基础值对直立倾斜试验阳性结果的影响。方法不明原因晕厥病人51例,行45min基础直立倾斜试验(head-uptilttest,HUT),阴性病人保持70°倾斜角,直接含服硝酸甘油0.25mg,继续20min试验;HUT阳性病人按晕厥反应类型分为血管抑制型组、心脏抑制型组与混合型组。比较基础血压和基础心率。按血压140/90mmHg与心率(60次/分)为界分别分为高血压组与非高血压组,心率偏慢组与心率正常组。结果HUT阳性组率为62.7%(32/51),其中血管抑制型21例;心脏抑制型5例;混合型6例;阴性19例。HUT阳性组病人的血压与心率基础值与HUT阴性者差异无统计学意义(P>0.05)。晕厥发生率:高血压组62%(8/13),血压正常组63%(24/38),差异无统计学意义;心率偏慢组3/5,心率正常组60%(29/46),差异无统计学意义。结论血压与心率基础值对HUT没有明显影响,不能作为HUT试验阳性的预测指标。

Objectives To investigate the effect of basic blood pressure （BBP） and basic heart rate （BHR） on the tilt-testing result. Methods 51 patients included 21 male and 30 female, mean age （46±11）years（from 16 to 72）with syncope unknown origin were accepted for head-up tilt test （HUT）,the patients had negative result were continued to medicine-potentiated HUT （administered sublingual nitroglycerin 0.25 mg）.（1）According to the response type,total patients had positive response were divided into three groups： the vasodepressor type; the cardioinhibitory type; the mixed type. Each group compared with the negadve group. （2）According to the data of BBP and BHR, they were also divided into two sections： the hypertension group （HBP,BP≥ 140/90mmHg）, compared with the non-hypertension group （NHBP,BP〈140/90mmHg）; the low-heart rate group（LHR,HR〈60bpm）, compared with the normal-heart rate group（NHR,HR≥60bpm）. Results （1）21 cases applied to the vasodepressor type, cardioinhibitory type 5 cases, mixed type 6 cases; 19 cases were negative response to the testing, the total positive rate was 62.7%. the BHP and BHR in three groups had no significant difference compared with the negative one （p〉0.05）. （2） 8 cases （8/13） occurred syncope （61.6%） in the HBP （142.8±21.5 mmHg） group, compared with 24 （24/38, 63.1%） in the NHBP （121.4±12.7 mmHg） group; 3 cases （3/5） occurred syncope （63%） in the LHR （56.3±2.3bpm） group, compared with 29 （29/46,60%） in the NHR group. There was no significant differences in the percentage of positivity between the HBP and NHBP group neither between the LI/R and NHR group. Conclusions BBP and BHR index do not effect the HUT result, they are not the index of predicting the positive result.