舌下含服双硝基异山梨醇直立倾斜试验对血管迷走性晕厥的诊断价值

Value of head up tilt testing with sublingual isosorbid dinitrate for the diagnosis of vasovagal syncpoe

目的 探讨舌下含服双硝基异山梨醇 (消心痛 )直立倾斜试验 (S .ISD HUT) ;对血管迷走性晕厥 (VS)的诊断价值。方法 对 87例晕厥患者和 40例对照组 ,经基础直立倾斜试验 (B HUT)后 ,阴性者再行S .ISD HUT观察倾斜前后血压 ,心率、12导心电图、症状以及服用消心痛以后的变化。结果 B HUT阳性诱发率在VS组为 2 4%、对照组为2 5% ;VS组和对照组在S .ISD HUT中的阳性诱发率分别为3 7/ 66(56 1% )、6/ 3 9(15 4% ) ;B HUT和S .ISD HUT在VS组中诱发阳性的时间分别是 19± 13 (5～ 2 7)min和 4± 6(2～8)min、P <0 0 5;药物引起低血压发生率在VS组和对照组分别为 9 1%和 7 7% ;S .ISD HUT诱发VS的敏感性 66 7%特异性是 85%。结论 S .ISD HUT对VS的诊断有较高的特异性和敏感性 ,且方便易行 ,安全可靠 ;

Objectives To study value of head up tilt table test with sublingual isosorbid dinitrate for the diagnosis of vasovagal syncope. Methods 87 patients with vasovagal syncope and 40 subject in control group were studied. The patients and the subjects in the control group underwent baseline head up tilt table tests(B HUT). If positive response did not occur, sublingual isosorbide dinitrate head up tilt tests(S.ISD HUT) was underwent. Blood pressure, heart rate, 12 1ead electrocardiogram and symptoms were observed before and after tests, their changes after sublingual isosorbid dinitrate were collected. Results positive rates of B HUT were 24% and 2 5% in VS and the controls respectively, while they were 56 1%(37/66), 15 4%(6/39) respectively when with S.ISD HUT. The positive inducing time in VS were 19±13(5～27)min and 4±6(2～8)min by B HUT and S. ISD HUT repectively( P <0 05). The rates of drug induced hypotension were 9 1% in VS and 7 7% in the controls. The sensitivity and specifity were 66 7% and 85% in VS by S.ISD HUT. Conclusions ISD HUT is much sensitivity and specif ity for diagnosis of VS it also is convenient and safe.