直立倾斜试验阳性反应发生时间的影响因素研究

Factors influencing starting time of positive reaction during head-up tilt test

目的探讨性别、年龄、基础心率、基础收缩压及基础舒张压对直立倾斜试验阳性反应发生时间的影响。方法选择2007年1月~2017年4月因晕厥在泰达国际心血管病医院就诊且直立倾斜试验检查阳性患者761例,分为基础试验阳性者141例与激发试验阳性者620例,分析2种试验的阳性反应发生时间与性别、年龄等因素的相关性。结果在基础试验中,与年龄≤30岁患者相比,年龄≥60岁患者阳性反应发生时间明显延长[(26.48±7.70)min vs(19.50±9.66)min,P<0.05];与男性比较,女性阳性反应时间明显延长,差异有统计学意义[(25.12±9.94)min vs(21.32±9.54)min,P=0.023];男性患者阳性反应发生时间随年龄增大呈逐渐延长的趋势,与年龄≤30岁、31~59岁男性患者相比,年龄≥60岁男性患者阳性反应发生时间明显延长,差异有统计学意义(P<0.01);而随年龄的增长,女性患者阳性反应发生时间先延长后缩短,与年龄≤30岁、≥60岁女性患者比较,31~59岁女性患者阳性反应发生时间有所延长,但三者比较无统计学差异(P>0.05)。在激发试验中,与女性比较,男性阳性反应发生时间明显延长,差异有统计学意义[7(5,10)min vs 6(5,9)min,P=0.007]。结论在基础试验阳性患者中,女性阳性反应发生时间较男性延迟,男性随着年龄的增长,阳性反应发生时间逐渐延迟。而在激发试验阳性患者中,仅发现男性患者出现阳性反应的时间比女性延迟,与其他因素无关。

Objective To study the effect of gender,age,HR,SBP and DBP on starting time of positive reaction during head-up tilt test.Methods Seven hundred and sixty-one positive head-up tilt test patients admitted to TEDA international cardiovascular hospital due to syncope were divided into basic experimental group（n=141）and provocation experimental group（n=620）.Relationship of starting time of positive reaction with gender,age,HR,SBP and DBP was analyzed.Results The starting time of positive reaction was significantly longer in≥60 years old patients than in≤30 years old patients of basic experimental group and in female patients than in male patients（26.48±7.70 min vs 19.50±9.66 min,P=0.012;25.12±9.94 min vs 21.32±9.54 min,P=0.023）.The starting time of positive reaction increased with the increasing age in male patients and was significantly longer in ≥60 years years old patients than in ≤ 30 and 31-59 years old patients（P=0.001,P=0.003）.The starting time of positive reaction increased first and then decreased with the increasing age in female patients.However,no significant difference was found in starting time of positive reaction in ≤30,≥60 and 31-59 years old patients（P〈0.05）.The starting time of positive reaction was significantly longer in male patients than in female patients of provocation experimental group（P=0.007）.Conclusion The starting time of positive reaction of basic experiment is longer in female patients than in male patients and increases with age in male patients.However,the starting time of positive reaction is longer in male patients than in female patients with positive provocation test,and is independent of other factors.