摘要
目的:观察直立倾斜试验在血管迷走性晕厥诊断中的效能。方法:回顾性分析2020—2023年该院收治的62例不明原因晕厥史患者的临床资料。所有患者均行传统心电图检查和直立倾斜试验,以临床综合评估结果作为金标准,比较心电图检查、直立倾斜试验在血管迷走性晕厥诊断中的效能;比较心电图检查、直立倾斜试验对不同类型晕厥的检出率,以及不同时间的心率、血压水平。结果:金标准检查结果显示,阳性48例,阴性14例;传统心电图检查结果显示,阳性40例,阴性22例;直立倾斜试验结果显示,阳性47例,阴性15例。直立倾斜试验诊断血管迷走性晕厥的准确度、灵敏度均高于传统心电图检查,差异有统计学意义(P<0.05)。直立倾斜试验对血管抑制型、心脏抑制型晕厥的检出率均高于传统心电图检查,差异有统计学意义(P<0.05)。晕厥即刻,血管抑制型、心脏抑制型及混合型晕厥患者的心率、收缩压、舒张压水平均低于平卧时,差异有统计学意义(P<0.05);心脏抑制型、混合型晕厥患者的心率均低于血管抑制型晕厥患者,混合型晕厥患者的心率与心脏抑制型患者比较,差异无统计学意义(P>0.05);心脏抑制型、混合型晕厥患者的收缩压水平均高于血管抑制型晕厥患者,混合型晕厥患者的收缩压水平低于心脏抑制型晕厥患者,差异有统计学意义(P<0.05);心脏抑制型患者的舒张压水平高于血管抑制型和混合型晕厥患者,混合型晕厥患者的舒张压水平与血管抑制型晕厥患者比较,差异无统计学意义(P>0.05)。结论:直立倾斜试验在血管迷走性晕厥诊断中的效能高于传统心电图检查效能。
Objective:To observe efficiency of head-up tilt test in diagnosis of vasovagal syncope.Methods:The clinical data of 62 patients with unexplained syncope admitted to the hospital from 2020 to 2023 were retrospectively analyzed.All patients underwent traditional electrocardiogram examination and head-up tilt test.Using the results of clinical comprehensive evaluation as the gold standard,the efficiencies of electrocardiogram examination and head-up tilt test in the diagnosis of vasovagal syncope were compared.Further,the detection rates of different types of syncope by electrocardiogram and head-up tilt test,as well as the heart rate and blood pressure levels at different times were compared.Results:The gold standard examination showed that 48 cases were positive and 14 cases were negative.The traditional electrocardiogram showed that 40 cases were positive and 22 cases were negative.The head-up tilt test showed that 47 cases were positive and 15 cases were negative.The accuracy and sensitivity of upright tilt test in the diagnosis of vasovagal syncope were higher than those of traditional electrocardiogram,and the differences were statistically significant(P<0.05).The detection rates of vasodepressor syncope and cardioinhibitory syncope by head-up tilt test were higher than those by traditional electrocardiogram,and the differences were statistically significant(P<0.05).Immediately after syncope,the levels of heart rate,systolic blood pressure and diastolic blood pressure of the patients with vasodepressor,cardioinhibitory and mixed syncope were lower than those in supine position,and the differences were statistically significant(P<0.05).The heart rate of the patients with cardioinhibitory and mixed syncope was lower than that of the patients with vasodepressor syncope.There was no significant difference in heart rate among the patients with mixed syncope and the patients with cardioinhibitory syncope(P>0.05).Further,the systolic blood pressure levels of the patients with cardioinhibitory and mixed syncope were higher than those of the patients with vasodepressor syncope;the systolic blood pressure levels of the patients with mixed syncope were lower than those of the patients with vasodepressor syncope;the differences were statistically significant(P<0.05).Conclusions:The efficiency of head-up tilt test in the diagnosis of vasovagal syncope is higher than that of traditional electrocardiogram.
作者
吴浩
WU Hao(Department of Cardiology of Zunyi Hospital of Traditional Chinese Medicine,Zunyi 563000 Guizhou,China)
出处
《中国民康医学》
2025年第4期107-109,131,共4页
Medical Journal of Chinese People’s Health
关键词
直立倾斜试验
传统心电图检查
晕厥
效能
Head-up tilt test
Traditional electrocardiogram examination
Syncope
Efficiency
作者简介
吴浩(1987.09-),男,汉族,贵州遵义人,本科,主治医生,研究方向为晕厥相关诊断及治疗。
