血管迷走性晕厥不同分型的比例及影响因素

Prevalence of Different Types and Influencing Factors of Vasovagal Syncope

血管迷走性晕厥分型的比例在不同的医疗中心的报道中差距较大,成年血管迷走性晕厥患者中1型混合型的比例为17.4%~67.2%,2型心脏抑制型的比例为0%~31.5%,3型血管抑制型的比例为21.3%~74.8%。未成年血管迷走性晕厥患者中混合型的比例为22.7%~49.5%,心脏抑制型的比例为0%~31.6%,血管抑制型的比例为23.7%~73.6%。本研究总结了可能影响血管迷走性晕厥分型比例的因素:(1)年龄。年龄与血管迷走性晕厥分型之间关系的研究结果互相矛盾。(2)性别。男性和女性的性别差异与血管迷走性晕厥的分型可能不相关。(3)合并基础疾病。高血压在高龄患者中可能与血管抑制型的发生相关,糖尿病、冠心病、心力衰竭可能不是影响分型的因素。(4)发病时和倾斜试验中的临床表现。发病时表现为晕厥可能与混合型的发生相关,直立倾斜试验中表现为晕厥合并癫痫样活动可能与心脏抑制型和混合型的发生相关。(5)医生进行直立倾斜试验检查的经验。检查医生对阳性时间的判断是影响分型的因素,提前结束试验会导致一部分心脏抑制型患者误诊。

The prevalence of types of vasovagal syncope(VVS) varied significantly among studies from various medical centers.In adult patients with VVS,the prevalence of type 1 mixed ranged from 17.4% to 67.2%,type 2 cardioinhibitory ranged from 0% to 31.5%,and type 3 vasodepressor ranged from 21.3% to 74.8%.The prevalence of VVS in children and adolescents were also varied in mixed(22.7% to 49.5%),cardioinhibitory(0% to 31.6%),and vasodepressor(23.7% to 73.6%).This review summarized the factors that may affect the prevalence of different types of VVS,including:(1) Age:The influence of age on the prevalence of different types of VVS are inconsistent.(2) Gender:The relationship between gender and the occurrence of VVS was not determined.(3) Co-Morbidities:Hypertension may be a contributing factor to the occurrence of vasodepressor in elderly patients,whereas diabetes,coronary heart disease,and heart failure may have no impact on the types of VVS.(4) Clinical symptoms and that during head-up tilt test:The presence of syncope may indicate a higher probability of developing a mixed.The occurrence of seizure-like activities during the head-up tilt test may indicate a higher probability of developing a cardioinhibitory or mixed.(5) Doctor's experience in performing head-up tilt test:The VVS types might be affected by experience of doctor,and prematurely ending the test may result in the misdiagnosis of some patients with cardioinhibitory.