直立倾斜试验对血管迷走神经性晕厥的诊断价值

目的　探讨直立倾斜试验对血管迷走性晕厥的诊断价值及其局限性。方法　对 12 9例不明原因晕厥患者及 5 4名无晕厥病史健康对照者进行直立倾斜试验 ,先进行基础倾斜试验 (倾斜 70°、持续 30 min) ,阴性者再进行两阶段的异丙肾上腺素的激发试验。结果　 112 9例晕厥患者中 ,倾斜试验阳性者 88例 (阳性率 6 8.2 % ) ,5 4名对照组中阳性者 6名 (阳性率 11.1% ) ,晕厥组阳性率明显高于对照组 ,差异有显著性 (P<0 .0 0 5 )。本次试验的灵敏度 6 8.2 % ,特异度 88.9%。 2患者年龄越大阳性反应率越低 (P<0 .0 5 ) ,性别对试验的阳性反应率影响不显著 (P=0 .31)。结论　倾斜试验设备简单、易于操作、是血管迷走性晕厥的一项比较安全有效的诊断方法。

Clinical diagnostic value of head upright tilt testing in patients with vasovagal syncope

Objective To assess the clinical diagnostic value and limitation of head upright tilt testing (HUT).Method HUT was performed in 129 patients with recurrent unexplained syncope and 54 healthy control subjects without syncope.Result Eighty-eight of 129 patients (68.2%) had positive response to HUT;6 of 54 subjects in control group (11.1%) had positive result.The positive rate was significantly higher in the patients than that in control group (P<0 005).The sensitivity was 68.2%.Specificity was 88.9%.The positive rate decreased with the age increasing (P<0 05).The influence of gender was not significant (P=0 31).Conclusion HUT is a reliable method to detect vasovagal syncope.It is a sensitive,specific,safe and simple clinical diagnostic method.