倾斜试验加异丙肾上腺素静滴用于血管迷走神经性晕厥的诊断

Utility of Isoproterenol-Tilt Table Testing in The Diagnosis of Vagovagal Syncope

本文研究倾斜体位加异丙肾上腺素静滴诱发血管迷走神经性晕厥,12例有晕厥史的病人中9例诱发出晕厥,而6例正常人无1例阳性.晕厥发作时伴有血压明显下降;试验结束时,阳性组和对照组收缩压比较为10±1.2kPa(75±9mmHg)vs13.3±0.65kPa(100±5mmHg)(P<.001),舒张压力5.3±1.3kPa(40±10mmHg)vs8.3±0.4kPa(62±3mmHg)(P<0.001),阴性组和对照组相比无差异;晕厥发生在倾斜后7±3.2分钟,晕厥时血压处于最低点即收缩压由倾斜开始时的14.9±1.9kPa(112±14mmHg)降到10±1.2kPa(75±9mmHg)(P<0.001),舒张压由10±1,2kPa(72±9mmHg)降至5.3±1.3kPa(40±10mmHg)(P<0.001);阳性组中有2例低血压同时伴心动过缓.倾斜体位加异丙肾上腺素静滴方法用于诊断血管迷走神经性晕厥简单、安全、且为非创伤性手段,对临床诊治有一定帮助.

The study investigated vagovagal syncope evoked by tilt table testing with an infusion of isoproterenol. Twelve patients with syncope of unknown origin and six control subjects with no history of syncope were evaluated, syn-cope were provoked in nine patients,all of whom had his-tory of syncope. During syncope sys tolic blood pressure and diatolic blood pressure decreased sharp ly ( 75±9mmHg vs 100±5?mmHg,p<0. 001,40±10mmHg vs 62±3mmHg,p<0. 001). It occured in 7±3.2 min af-ter tilt. Among the patients, two had both hypotension and bradycardia. The syncopes occured at the nadir of blood pressure. This method is a simple, safe and noninvasive way in diagnosing vasovagal syncope.