论文部分内容阅读
目的探讨直立倾斜试验(HUTT)阳性反应患者心律失常发生的特点。方法对2000年9月至2005年7月在中南大学湘雅第二医院晕厥专科门诊就诊或住院的不明原因晕厥或接近晕厥患者进行HUTT检查(所有患者均签署知情同意书)。分析HUTT过程中心律失常发生情况。采用SPSS10.0统计软件进行统计学处理。结果127例HUTT阳性反应患者中122例(96.06%)患者出现心律失常。107例(84.25%)发生快速性心律失常,并在儿童及舌下含服硝酸甘油倾斜试验(SNHUT)中发生率高(P<0.01),无性别差异(P>0.05)。快速性心律失常以窦性心动过速(98.13%,105/107)多见,其中99例(94.29%)患者在心率达最快后5min内,平均(1.73±1.72)min发生阳性反应。58例(45.67%)患者发生缓慢性心律失常,窦性心动过缓多见(91.38%,53/58),常合并交界性逸搏心律、交界性逸搏和窦性停搏。10例窦性停搏患者平均停搏时间为(12.68±17.94)s。缓慢性心律失常患者基础心率偏慢,且在成人及基础直立倾斜试验(BHUT)过程中发生率高(P<0.05或P<0.01),而男女性别差异无显著性(P>0.05)。结论(1)HUTT过程中心率突然明显增快时应警惕阳性反应的发生。(2)缓慢性心律失常在成人及BHUT中发生率较高,常见类型有窦性心动过缓、窦性停搏、交界性逸搏心律、交界性逸搏等,发生缓慢性心律失常患者的基础心率偏慢。
Objective To investigate the characteristics of cardiac arrhythmia in patients with positive tilt-tilt test (HUTT). Methods HUTT was performed on patients with unexplained syncope or near syncope from September 2000 to July 2005 at the Second Xiangya Hospital of Central South University. All patients received informed consent. Analyze the occurrence of arrhythmia during HUTT. Using SPSS10.0 statistical software for statistical analysis. Results 122 cases (96.06%) of 127 HUTT positive patients had arrhythmia. 107 cases (84.25%) had tachyarrhythmia and had a high incidence of SNHUT in children and sublingual nitroglycerin (SNHUT) (P <0.01), but no gender difference (P> 0.05). Tachyarrhythmia was more common in sinus tachycardia (98.13%, 105/107), of which 99 (94.29%) patients had an average response rate of 1.73 ± 1.72 min within 5 min of the fastest heart rate. Fifty-eight patients (45.67%) had bradyarrhythmia. The patients with sinus bradycardia were more common (91.38%, 53/58), and were often associated with borderline esophageal arrhythmia, borderline esophageal ametropia and sinus arrest. The mean arrest time of 10 patients with sinus arrest was (12.68 ± 17.94) s. The basal heart rate was slow in patients with bradyarrhythmia and had a high incidence (P <0.05 or P <0.01) in both adults and patients with BHUT (P <0.01). There was no significant difference between men and women (P> 0.05). Conclusions (1) The occurrence of positive reaction should be vigilant when the heart rate suddenly increases obviously during HUTT. (2) The incidence of bradyarrhythmia in adults and BHUT is high, common types of sinus bradycardia, sinus arrest, borderline escape rhythm, borderline esophageal arrhythmias, patients with bradyarrhythmia Basal heart rate is slow.