血管迷走性晕厥的家族遗传特征

Familial hereditary features in the patients with vasovagal syncope

目的探讨血管迷走性晕厥(VVS)患者的家族遗传特征。方法对383例行倾斜试验(HUTT)检查的不明原因晕厥(UPS)患者详细询问晕厥家族史,并记录建档。结果①9.4%(36/383)UPS患者存在晕厥家族史,HUTT阳性且有晕厥家族史者占12.0%(23/191)。②UPS患者女性明显多于男性,男性有晕厥病史者其后代(一级亲属)男性晕厥发病几率增加18.6%,女性有晕厥病史者其后代(一级亲属)发生晕厥比率女性>男性。③UPS患者21.7%(83/383)、有晕厥家族史且HUTT阳性患者39.1%(9/23)晕厥发作时存在诱因。④有晕厥家族史且HUTT阳性患者混合型比率高于全体HUTT阳性患者(34.8%vs27.7%)。⑤HUTT阳性患者有无晕厥家族史在性别及年龄组间(<18岁与≥18岁)比较差异无统计学意义(P>0.05)。结论VVS存在遗传倾向,尤其是一级亲属有晕厥史者后代晕厥发生几率明显增高,外界因素可促进晕厥发生。

Objective To investigate familial hereditary features in the patients with vasovagal syncope（VVS）. Methods Undergoing head - up tilt table test（ HUTT）, 383 patients with unexplained syncope （ UPS ） were carefully inquired familial syncope history and filed. Results 36 of the 383 patients （9.4% ）with UPS had familial syncope history, and 23 patients of them were positive in HUTT, and accounted for 12 % （23/191）. Females were more than males in all patients with UPS. Males with syncope history significantly increased the risk of syncope by 18.6% in male - offspring of first - degree relatives. Females were more likely to faint than males, whose female - predecessors of first - degree relatives fainted. Inducement existed in 83 of the 383 UPS patients （ 21.7% ） and 9 of the 23 positive patients （ 39. 1% ） with familial syncope history. Mixed response was relatively higher in positive patients who had familial syncope history than all positive patients, which was 34.8% and 27.7%, respectively. Positive patients with or without, familial syncope history didnt show significant differences between males and females or between different age groups（ 〈 18 years and ≥ 18 years ） （ P 〉 0. 05 ）. Conclusions There is a hereditary tendency for VVS, especially first - degree relatives have syncope history whose offsprings are more likely to faint . Environmental stimulus may accelerate the occurrence of syncope.