舌下含服硝酸甘油倾斜试验诊断血管迷走性晕厥的价值

目的　探讨舌下含服硝酸甘油倾斜试验 (NTTT)对血管迷走性晕厥的诊断价值。方法　 35例不明原因性晕厥患者进行倾斜试验并以 2 2例正常人作对照组。结果　晕厥组基础倾斜试验 (BTTT)阳性 8例 (2 2 .86% ) ,对照组基础倾斜试验无 1例阳性。舌下含服 0 .3mg硝酸甘油后有 1 9例阳性 (70 .37% ) ,对照组阳性 1例 ,假阳性率为 5% ,两组阳性率有显著性差异 ,P<0 .0 1。晕厥组两种试验阳性率仍有显著性差异 ,P<0 .0 1。 NTTT敏感性为 77.1 4 % ,特异性为95.45% ,诊断价值为 81 .63%。结论　倾斜试验采用 80°角 ,持续 45min,含服 0 .3mg硝酸甘油对血管迷走性晕厥的诊断具有一定临床应用价值

Study of the Value of Sublingual Nitroglycerin Administration during Upright Tilt Test in Diagnosis of Vasovagal Syncope

Objective To investigate the value of sublingual nitroglycerin administration during upright tilt as a simple practical test for the diagnosis of vasovagal syncope.Methods 35 cases of syncope with unknow causes and 22 healthy persons were analysed.Results 8 cases in experimental group showed positive reaction to BTTT(22.86%),while no one in control group was positive.After 0.3mg(300micrograms) of sublingual nitroglycerin,a positive response occurred in patients(70.37%) and in 1 control (false positive rate 5%),meaning significant difference.(P<0.01).The difference between BTTT(22.86%) and NTTT was also significant(P<0.01) in experimental group.The sensibility and specificity of NTTT were 77.14% and 95.45%, respectively,and its diagnostic value was 81.63%.Conclusions That patients were tilted at 80 degrees for 45 minutes and sublingual administration of 0.3mg nitroglycerin should have some value of clinical application in the diagnosis of vasovagal syncope.