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目的 血管迷走性晕厥在直立倾斜试验中房室间期变化。方法 收集2018年1月至2020年12月江门市中心医院门诊及住院共78例直立倾斜试验阳性的晕厥、晕厥先兆患者(男性34例,女性44例,平均年龄37.87±19.10岁),并分析了直立倾斜试验期间患者在平卧位、直立倾斜位、晕厥前和恢复平卧位后的房室间期数据。结果 其中2型血管迷走性晕厥患者在晕厥前房室间期为(150.50±10.60)ms,较直立倾斜位的(132.50±7.33)ms延长(P<0.05);1型血管迷走性晕厥患者在晕厥前房室间期为(118.29±7.78)ms,较直立倾斜位的(133.14±5.38)ms缩短(P<0.05);3型血管迷走性晕厥患者在晕厥前房室间期为(122.10±6.25)ms,较直立倾斜位的(139.93±4.32)ms缩短(P<0.05)。年龄分析结果显示,儿童组别中各类型的晕厥前房室间期较直立倾斜位均缩短,但在3型血管迷走性晕厥中两者之间差异没有统计学意义,成年组中1型血管迷走性晕厥及3型血管迷走性晕厥患者晕厥前房室间期较直立倾斜位均缩短,而2型血管迷走性晕厥则延长。不同性别的比较分析显示,男性及女性在各型晕厥时各体位的房室间期变化情况与总体分析的结果类似。结论 血管迷走性晕厥1型在晕厥或晕厥先兆时伴随房室间期延长、窦性搏动减慢或高度以上的房室阻滞,甚至心脏停搏,而1型及3型血管迷走性晕厥出现房室间期缩短,提示不同类型的血管迷走性晕厥对房室间期影响机制不一样,可作为今后晕厥发生的预警。儿童组自主神经系统功能尚未成熟,结果与成人不同,但需要加大样本量再进行分析。
AponteBecerra Laura,Novak Peter.Tilt Test.[J].Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society,2021.
Harteveld Lisette M,Nederend Ineke,Ten Harkel Arend D J,Schutte Nienke M,de Rooij Susanne R,Vrijkotte Tanja G M,Oldenhof Helena,Popma Arne,Jansen Lucres M C,Suurland Jill,Swaab Hanna,de Geus Eco J C.Maturation of the Cardiac Autonomic Nervous System Activity in Children and Adolescents.[J].Journal of the American Heart Association,2021.
Awaneesh Kumar,Keith Wright,Domingo E. Uceda,Peter A. Vasallo,Perry L. Rabin,David Adams,Johnson Wong,Mithilesh Das,Shien-Fong Lin,Peng-Sheng Chen,Thomas H. Everett.Skin sympathetic nerve activity as a biomarker for syncopal episodes during a tilt table test[J].Heart Rhythm,2020(5).
Toshiyuki Furukawa.Role of head-up tilt table testing in patients with syncope or transient loss of consciousness[J].Journal of Arrhythmia,2017.
Mehlsen Jesper,Kaijer Michelle Nymann,Mehlsen Anne-Birgitte.Autonomic and electrocardiographic changes in cardioinhibitory syncope.[J].Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology,2008.
Schiereck P,Sanna N,Mosterd W L.AV blocking due to asynchronous vagal stimulation in rats.[J].American journal of physiology. Heart and circulatory physiology,2000.
Maloney J D,Jaeger F J,Fouad-Tarazi F M,Morris H H.Malignant vasovagal syncope: prolonged asystole provoked by head-up tilt. Case report and review of diagnosis, pathophysiology, and therapy.[J].Cleveland Clinic journal of medicine,1988(6).
Pfeifer M A,Weinberg C R,Cook D,Best J D,Reenan A,Halter J B.Differential changes of autonomic nervous system function with age in man.[J].The American journal of medicine,1983(2).
刘杰昕,杜嵩,王跃,金泽宁,黄泽民,宋柯,樊志奇,陈章煌,吴斌.0.25?mg低剂量硝酸甘油激发直立倾斜试验在血管迷走性晕厥诊断中的应用[J].中国卒中杂志,2020(06).
刘文玲.晕厥诊断与治疗中国专家共识(2018)解读[J].中国实用内科杂志,2019(11).
何佳,时晓蕾,张怡,施露,李夏华,黄建凤.疑诊血管迷走性晕厥患者中直立倾斜试验阳性者的心电图特征[J].中国循环杂志,2017(08).
直立倾斜试验标准操作流程中国专家推荐意见[J].中国循环杂志,2016(08).
刘杰昕,李秦,李虹伟.倾斜试验[J].北京医学,2014(01).
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