单腔起搏对血管迷走性晕厥的疗效探讨

Evalution of VVI/VVIR pacing for recurrent vasovagal syncope

目的:探讨应用单腔起搏器治疗血管迷走性晕厥(VVS)的效果。方法:将确诊为VVS的患者42例,随机分为起搏器组(22例)和药物治疗组(20例)进行疗效对照。起搏器组置入单腔起搏器(VVI 10例,VVIR12例),药物治疗组口服美托洛尔治疗。2组患者出院后6个月均复查直立倾斜试验并随访,观察对晕厥的预防效果。结果:起搏器组直立倾斜试验阴转率82.0%,无一例发生晕厥,2例仍有晕厥先兆,但症状明显减轻;药物治疗组直立倾斜试验阴转率50.0%,8例发生晕厥,但发作次数减少。2组直立倾斜试验阴转率和晕厥发生率比较,差异均有统计学意义(P<0.01)。结论:对于反复发作的VVS患者,安装起搏器可以有效防止晕厥的发生,药物治疗亦有一定疗效,但不能完全防止晕厥的发生。

Objective：To investigate the effect of VVI/VVIR pacing on vasovagal syncope（VVS）. Method：Forty-two patients diagnosed as VVS by tilt tble test（TTT） in Wuhan Puai Hospital were selected into the study.They were divided into two groups randomly： group with pacemaker（22） and group with drugs（20）.Tilt tble test was examined again after six months and follow-up. Result：The rate of TTT from positive to negative was 82% in group with pacemaker,50% in group with drugs.The two groups had a statistical difference（P0.01）.All the 22 patients with pacemaker implantation were free from syncope,in which 2 still had per-syncope discomfortness,but the syncope onset was slightly.Twelve cases relapse of syncope in the groups with drugs during the follow-up period.The two groups also had a statistical difference（P0.01）. Conclusion：In the VVS patients with recurrent syncope,VVI/VVIR pacing could prevent from syncope efficiently.Drug therapy also was effective,but syncope can not be prevented.