直立倾斜试验在心脏神经官能症患者中鉴别血管迷走性晕厥的应用分析

Application of head-up tilt test in identification of vasovagal syncope in patients with cardiac neurosis

目的探讨直立倾斜试验(HUTT)在心脏神经官能症患者中鉴别血管迷走性晕厥(VVS)的应用价值,为临床应用提供指导。方法回顾性分析2019年1月至12月于咸阳市中心医院行直立倾斜试验的1184例心脏神经官能症的患者资料,观察受试者直立倾斜试验阳性结果情况,分析不同性别、年龄组间结果的差异。结果受试者中直立倾斜试验阳性583例,阳性率49.2%;其中混和型VVS 424例(72.7%),心脏抑制性VVS 8例(1.4%),血管抑制型VVS 151例(26.0%);不同性别患者间阳性率差异有统计学意义(P<0.05),不同性别阳性类型差异亦有统计学意义(P<0.05)。将阳性组以65岁为界,按年龄分为两个亚组,小于65岁者阳性率高于65岁及以上者(P<0.05)。结论直立倾斜试验在心脏神经官能症患者中鉴别血管迷走性晕厥具有较好的临床价值,年轻女性患者阳性率显著增高。

Objective To discuss the application value of head-up tilt test(HUTT)in identification of vasovagal syncope(VVS)in patients with cardiac neurosis.Methods The materials of patients(n=1184)undergone HUTT in Central Hospital of Xianyang City were retrospectively analyzed from Jan.2019 to Dec.2019.The positive results of HUTT were observed in all patients,and difference among different gender groups and age groups were analyzed.Results There were 583 cases(49.2%)with positive results of HUTT.Among them,there were 424 cases of mixed VVS(72.7%),8 cases of cardiac inhibition VVS(1.4%)and 151 cases of vascular inhibition VVS(26.0%).The difference in positive rate had statistical significance in patients of different genders(P<0.05),and difference in positive type had statistical significance in patients of different genders(P<0.05).The positive group was divided into 2 subgroups according to age taken 65 year-old as a bound,and positive rate of HUTT was higher in patients under 65 year-old than that in those over 65 year-old.Conclusion HUTT has a higher clinical value in VVS identification in patients with cardiac neurosis,and positive rate of HUTT increases significantly in younger female patients.