直立倾斜试验诊断不明原因晕厥的价值

Significance value of head-up tilt test in diagnosing unexplained syncope

目的探讨直立倾斜试验在不明原因晕厥诊断中的价值。方法不明原因晕厥患者366例，均行直立倾斜试验检查。结果直立倾斜试验阳性252例，阳性率68．9％；直立性不耐受综合征类型中以血管迷走性晕厥多见，其次为体位性心动过速、直立性低血压；血管迷走性晕厥中血管减压型比例女性高于男性（P〈O．05）；年龄≥60岁15例患者中直立倾斜试验阳性10例，均表现为血管迷走性晕厥；13例发生假性晕厥。结论直立倾斜试验阳性者并非为反射性晕厥，直立位3～45min发生晕厥的阳性患者，须结合年龄、性别及病史确诊是体位性晕厥或反射性晕厥。

Objective To explore the significance of head-up tilt test （HUTT） in the diagnosis of unexplained syncope. Methods A total of 366 patients with unexplained syncope underwent HUTT. Results In 366 patients, positive HUTT was observed in 252 patients （68.9%）. In orthostatic intolerance syndromes, vasovagal syncope was the most common type, followed by postural orthostatic tachycardia syndrome and orthostatic hypotension. The proportion of blood vessels suppression was larger in females than in males in patients with vasovagal syncope （P〈0.05）. In 15 patients aged 60 years or older, 10 patients had positive HUTT, which was demonstrated by vasovagal syncope. False syncope occurred in 13 patients. Conclusions Positive HUTT does not mean reflex syncope. Postural syncope or reflex syncope could be diagnosed combining the age, sex, and disease history when the syncope attacks in 3 to 45 minutes after HUTT.