自主神经功能检测对迷走性晕厥的诊断价值

Significance value of autonomic nerve function tests for diagnosis of vasovagal syncope

目的:探讨迷走性晕厥患者自主神经功能改变及其诊断价值。方法:对迷走性晕厥患者和健康者,分别测定其深呼吸心率变异、Valsalva比值、30 s最长RR间期/15 s最短RR间期(30/15)比值、卧立位血压和心率等自主神经功能,并检测了肾上腺素、去甲肾上腺素等激素水平。结果:迷走性晕厥患者深呼吸心率差、Valsal-va比值和卧至立位心率差[(9.8±1.6)次/min,1.09±0.03,(9.5±1.3)次/min],与对照组[(16.2±1.6)次/min,1.23±0.04,(15.4±1.7)次/min]相比,差异均有统计学意义(P<0.05)。迷走性晕厥患者晕厥时肾上腺素显著性增高[(100.8±38.9)ng/L],与对照组[(35.9±16.2)ng/L]相比,差异有统计学意义(P<0.05)。结论:迷走性晕厥患者自主神经明显受损,传统自主神经指标可作为诊断迷走性晕厥的一种新方法。

Objective：To evaluate the diagnostic value of autonomic function tests for vasovagal syncope.Method：Cardiovascular autonomic function tests,including 30∶15 postural ratio,heart rate change with deep respiration,response index of Valsalva maneuver,and postural change of heart rate and blood pressure,were performed in control group and vasovagal syncope group and plasmic adrenaline and norepinephrine were also measured.Result：Heart rate change with deep respiration,response index of Valsalva maneuver and postural change of heart rate of syncopal patients（[9.8±1.6]r/min,1.09±0.03,[9.5±1.3]r/min） have significantly lower than those of healthy subjects（P〈0.05）.Compared with control group,patients in vasovagal syncope group,who were occurring syncope,have significantly higher plasmic adrenaline.Conclusion：Vagal syncope patients significantly impaired autonomic nervous function,cardiovascular autonomic function can be used as a new diagnostic methods of vasovagal syncope.