两种直立倾斜试验诊断血管迷走性晕厥效果对比分析

目的探讨舌下含服硝酸甘油(NTG)和异丙肾上腺素静脉滴注(ISO)加倾斜试验(head-up tilt test,HUTT)诊断血管迷走性晕厥(vasovagal syncope,VVS)的效果对比。方法 40例无晕厥及晕厥前兆史的健康人与173例不明原因晕厥患者,均随机分为硝酸甘油组和异丙肾上腺素组,分别进行诱发试验,观察实验中受试者心率血压变化、阳性症状的出现及晕厥类型。结果两组均顺利完成试验,ISO组诊断的敏感性为56.0%,NTG组为70.8%;ISO组诊断的特异性为70.0%,而NTG组特异性为75.0%。差异有统计学意义(P<0.05)。结论硝酸甘油药物配合激发HUTT实验临床实用性较高,值得临床推广。

The Comparison and Analysis of Triglyceride and Isoprenaline on Induction of Vasovagal Syncope

Objective To discuss the effect of nitroglycerin (NTG) and Isoproterenol (ISO) in head-up tilt test to diagnose vasovagal syncope (VVS). Methods 40 cases of healthy persons without syncope and syncope precursor history and 173 cases of patients with unexplained syncope were respectively divided into NTG group and ISO group to receive the provocative test. The changes of heart rate and blood pressure, appearance of positive symptoms and syncope types were observed. Results Both groups had finished the test, with the diagnostic sensitivity of 56.0% in ISO group and 70.8% in NTG group, the diagnostic specificity of 70.0% in ISO group and 75.0% in NTG group; the differences between two groups had statistical significance (P <0.05). Conclusions Nitroglycerin-induced HUTT has strong clinical practicability, which is worthy of clinical promotion.