口服氨酰心安和依那普利治疗血管迷走性晕厥的疗效观察

A study on the effect of oral atenolol or enalaprol for vasovagal syncope

目的 观察口服氨酰心安和依那普利治疗血管迷走性晕厥的疗效。方法 对 48例直立倾斜试验 (head uptilttesting ,HUT)阳性的晕厥患者随机分三组治疗 :A组口服氨酰心安 ;B组口服依那普利 ;C组不给药物治疗 ,30天后复查HUT ,中短期随访晕厥复发率。结果 服药后HUT转阴率 :A组为 75 % ,B组为 5 6 3% ,C组为 18 8%。经 χ2 检验 ,A组与C组比较P <0 0 1,差异有显著性 ,而A组与B组和B组与C组比较P >0 0 5 ,差异无显著性。随访 1～ 14(7 4± 3 9)个月 ,三组晕厥复发率差异无显著性 ,A组耐受性好。结论 口服氨酰心安治疗血管迷走性晕厥 ,重复HUT转阴率高于依那普利 ,推测该药是防治血管迷走性晕厥的有效方法。但中短期治疗随访观察未见对晕厥复发率产生影响。

Objective To investigate the effects of oral atenolol or enalaprol on vasovagal syncope (VS) Methods 48 patients with syncope of unknown origin and positive response to head up tilt testing (HUT) were divided into three groups randomizely: group A for atenolol, group B for enalaprol and group C with no drugs They were examined again with the HUT after administration for one month The patient were followed up for 1 14 months to get the incidence of syncope recurrence rate Results In the HUT after treatment, the negative response occurred in 12 of 16 cases (75%) of group A, 9 of 16 cases (56 3%) of group B and 3 of 16 cases (18 8%) of group C Statistical analysis was done by using the chi square test There was a statistically significant difference between group A and group C ( P <0 01), but there was not among other groups The difference of syncope recurrence rate among all the three groups was not statistically significant after 7 4±3 9(1 14)months follow up Group A was well tolerated Conclusion The negative response rate in HUT after oral atenolol administration was higher than that of enalaprol administration These results indicate that atenolol orally may be effective for vasovagal syncope There was no effect on the incidence of syncope recurrence rate in the medium term follow up