北京某三甲医院132例中青年晕厥患者的临床分析

Clinical study on 132 working-age adults presenting syncope

目的通过收集中青年晕厥患者的临床资料,分析其临床特点,以期提高对18~60岁晕厥患者的临床理解和认识。方法对2018年5月至2020年10月就诊北京天坛医院诊断为“晕厥”的青年、中年患者132例开展回顾性研究,按照年龄35、45岁为临界值把患者群体分为青年组(18~35岁)、青壮年组(36~45岁)、中年组(46~60岁),收集患者一般资料,临床及实验室检查结果、1个月内的预后转归等信息。采用单因素方差分析、非参数检验等统计学方法探讨患者晕厥发作及发生短期不良事件的特点,并详细解析典型病例。结果中青年晕厥患者中神经介导性晕厥比例最高(80.30%),发生短期不良事件比例较低(27.36%),神经介导性晕厥的起始病因存在差异,与患者合并的基础疾病密切相关。心源性晕厥发生短期不良事件比例最高(61.11%),患者就诊时收缩压、末梢血氧饱和度、B型钠尿肽水平、血肌酐水平在短期不良事件发生与否的两组患者中存在显著差异(P<0.05)。结论中青年患者的晕厥发作虽然良性病因居多,但可能的严重病因在临床诊疗中不容忽略,要尽力查找原因及合并症,控制晕厥反复,避免不良事件发生。

Objective To enhance the understanding of working-age patients presenting syncope in the hospital by collecting the clinical data and analyzing their clinical characteristics.Methods From May 2018 to October 2020,132 working-age patients with syncope admitted in our hospital were investigated in the retrospective study.The patients were divided into very young adult group(18-35years old),young adult group(36-45years old)and middle-aged adult group(46-60years old)according to the cut-off age of 35 and 45.The characteristics of syncope episodes and short-term adverse outcomes in one month were explored through statistical analysis.Meanwhile,typical cases were explained in details additionally.Results In this study,the proportion of neurally-mediated syncope(NMS)was the highest(80.30%),and the incidence of short-term adverse outcomes was lower(27.36%).Moreover,the initial etiology of NMS was different,which was closely related to the patients’concomitant diseases.The incidence of short-term adverse outcomes in cardiac syncope was the highest(61.11%).Finally,there were some factors associated with significant differences in adverse incidences,such as systolic blood pressure,peripheral oxygen saturation,B-type natriuretic peptide level and serum creatinine level(P<0.05).Conclusion Most working-age patients have benign causes of syncope.However,the possible serious etiology still cannot be ignored in clinical practices,which might be valuable to find out the underly causes and concomitant diseases,to control the syncope recurrence and avoid adverse outcomes.