直立倾斜试验对咳嗽性晕厥患者的诊断价值研究

发布时间：2018-04-15 11:06

本文选题：咳嗽性晕厥 + 直立倾斜试验　；参考：《重庆医学》2017年28期

【摘要】：目的探讨直立倾斜试验(HUT)对咳嗽性晕厥(CS)的诊断价值。方法选取2011年1月至2016年5月该院门诊或住院CS患者47例作为观察组,同期有晕厥史的拟诊为血管迷走性晕厥(SVVS)的患者79例为对照组。两组均行HUT,观察HUT中咳嗽反应,咳嗽引发收缩压、舒张压及心率变化,HUT阳性结果及血流动力学类型。结果观察组患者咳嗽诱发晕厥4例(8.51%),晕厥先兆26例(55.32%),无症状17例(36.17%),对照组79例(100.00%)均无症状,差异有统计学意义(P0.05)。观察组咳嗽反应总阳性率为63.83%,特异性为100.00%。各组患者收缩压比较差异均有统计学意义(P0.05)。观察组无症状者舒张压与观察组晕厥者、观察组晕厥先兆者比较差异有统计学意义(P0.05),与对照组无症状者比较差异无统计学意义(P0.05)。各组心率比较差异无统计学意义(P0.05)。观察组患者HUT阳性率低于对照组(P0.05),两组间血流动力学类型差异均无统计学意义(P0.05)。结论 HUT中剧烈咳嗽可引起CS患者血压下降,诱发晕厥或晕厥先兆,能提高CS患者诊断的敏感性,对怀疑诊断为CS的患者,尤其是病史不清的CS患者的诊断是十分有益的。
[Abstract]:Objective to investigate the diagnostic value of vertical tilt test (HUTT) for cough syncope (CSS).Methods from January 2011 to May 2016, 47 patients with CS were selected as the observation group, and 79 patients with history of syncope were diagnosed as vasovagal syncope (SVVS) as control group.The cough response, systolic blood pressure induced by cough, diastolic blood pressure and heart rate in both groups were observed.Results there were no symptoms in 4 cases of cough induced syncope, 26 cases of syncope precursor, 36.17% of asymptomatic 17 cases and 79 cases of control group (P 0.05) in the observation group.The total positive rate of cough reaction in the observation group was 63.83 and the specificity was 100.00g.There were significant differences in systolic blood pressure (SBP) in all groups (P 0.05).There was significant difference in diastolic blood pressure (DBP) between the observation group and the observation group (P 0.05), and there was no significant difference between the observation group (P 0.05) and the control group (P 0.05).There was no significant difference in heart rate in each group (P 0.05).The positive rate of HUT in the observation group was lower than that in the control group (P 0.05). There was no significant difference in hemodynamic type between the two groups.Conclusion severe cough in HUT can decrease blood pressure and induce syncope or syncope in CS patients. It can improve the sensitivity of CS diagnosis. It is very helpful for patients suspected of CS, especially those with unclear history.
【作者单位】：河南省人民医院心功能科;
【基金】：河南省科学技术厅科技攻关基金资助项目(152102310419)
【分类号】：R741.04

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