硝酸甘油与异丙肾上腺素诱发血管迷走性晕厥的应用比较

The Comparison of Triglyceride and Isoprenaline on Induction of Unexplained Syncope

目的:探讨不同药物诱发血管迷走性晕厥的差别。方法:157例受试者,晕厥组127例,对照组30例,分为硝酸甘油(NTG)组和异丙肾上腺素(ISO)组,进行两阶段诱发试验,观察试验过程中血压心率的变化及伴随的临床表现,晕厥的发生及反应类型。结果:共有151例(96.2%)顺利完成试验,NTG组76例,阳性47例,阳性率61.8%,敏感性71%,特异性81.8%;ISO组75例,阳性49例,阳性率65.3%。敏感性68.2%,特异性84.3%,两组检出率的各参数差别无显著性;晕厥类型,NTG组混合型29例(61.7%),减压型14例(29.8%),心脏抑制型4例(8.5%),ISO组混合型28例(57%),减压型18例(36.7%),心脏抑制型3例(6.1%)两组反应类型无显著差别;用药到阳性反应时间分别是ISO组(7.8±3.6)分,NTG组(4.3±2.4)分,NTG组时间明显缩短。结论:本试验两组药物对比显示,NTG组用于不明原因引起的晕厥的诊断,具有与ISO组相近的敏感性及特异性,用药安全适应范围广、方便可靠、节省时间、副作用发生率低的特点,可作为常规试验诱发用药。

Objective： To observe the difference of triglyceride （NTG） and isoprenaline （ISO） on induction of syncope. Methods： There were 157 patients with 127 in the group of syncope and 30 in the control group, all these subjects divided randomly into two groups were to be administered with NTG and ISO respectively to induce syncope, so as to observe the blood pressure, heart rate and associated clinical manifestations, occurrence of syncope and their response types. Results： 151 （96.2%）pulled through the tests smoothly, 47 of 76 with syncope of in NTG group syncope, the rate was 61.8% , sensitivity was 71% , specificity was 81.8% ; 49 of 75 in the ISO group were induced to syncope, the rate was 65. 3% , sensitivity was 68. 2% , specificity was 84%. There was no significant difference between two groups. As to types of syncope, there were no significant difference between two groups ） for 29 mixed （61.7%）, 14 pure vasodepressor （29. 8% ）, 4 cardioinhibitory （8.5%） in ISO group and 28 （57%）, 18 （36. 7% ）, 3 （6. 1% ） in NTG group respectively. The time to induce syncope were （ 7. 8 ± 3.6 ） min in the ISO group and （4. 3 ± 2.4 ） min in NTG group. NTG significantly shortened the time to induce syncope. Conclusion： Compared with ISO, NTG can be used to in the tilt test diagnose syncope caused by unknown reasons and had similar sensitivity and specificity with ISO , however, it was much safer, more convenient and can be routinely used in tilt test to induce syncope.