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自主神经在血管迷走性晕厥发病中的作用 |
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罗维 任自文 丁燕生 吴林
张筠华 汪丽蕙 胡大一
【摘要】 目的 探索自主神经系统如何介导血管迷走性晕厥的发生。方法 对94例不明原因晕厥的病人进行了倾斜试验。倾斜过程中动态监测心电图、血压和心率。进行心率变异性分析。结果 44例发生晕厥，其中基础倾斜试验晕厥32例，阳性率34.0％；异丙肾上腺素晕厥12例，阳性率增加12.8％。晕厥时LF及HF明显下降，VLF明显升高。结论 （1）血管迷走性晕厥时，交感神经和迷走神经张力受抑制，导致血管扩张，血压下降。（2）VLF的升高与LF的下降明显相关。VLF升高的意义有待深入研究。
【关键词】 晕厥 倾斜台试验 心率变异性
The role of autonomic nervous system in vasovagal syncope Luo Wei, Ren Ziwen, Ding Yansheng, et al. Department of Cardiology, First Affiliated Hospital, Beijing Medical University, Beijing 100034
【Abstract】 Objective To study how the autonomic nervous system works in the vasovagal syncope.Me-thods Ninety-four patients with recurrent unexplained syncope underwent tilt table test. The analysis of the Holter-monitoring, blood pressure and the heart rate variability of the patients were performed during tilt. The LF, HF and VLF of frequency domain were studied for investigating the mechanism of vasovagal syncope. Results 44 among 94 patients had syncope. 32 got syncope during baseline tilt table test (BTTT), with the positive rate of 34.0% (32/94). 12 got syncope during isoproterenol-tilt table test, with the positive rate of 12.8% (12/94). LF and HF decreased significantly during syncope, meanwhile VLF significantly increased in all the patients with syncope.Conclusion (1) During the period of vasovagal syncope, both sympathetic and vagal nerve tones were inhibited. (2)The increase of VLF was significantly correlated to the decrease of LF. The significance of VLF increase remains to be observed.
【Key words】 syncope tilt-table test heart rate variability
不明原因的晕厥是临床诊断的难题。倾斜试验有助于血管迷走性晕厥的诊断。本研究旨在探讨倾斜试验诱发血管迷走性晕厥过程中自主神经的作用。
资料与方法
1.病例选择：病人来源于1995年10月～1996年8月在本院住院及门诊的不明原因晕厥病人共94例，其中男性31例，女性63例，年龄14～62（平均39.9）岁。
2.入选标准及方法：（1）有明确的晕厥病史。（2）半年内有过1次以上的晕厥发作。
经过详细询问病史，全身体格检查，常规心电图、超声心动图、X线胸片检查，确信无器质性心脏病，无高血压及高血压病史，动态心电图检查无明显心律失常，并除外与神[1] [2] 下一页
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