神经介导性晕厥发作的昼夜节律性研究

发布时间：2018-04-26 23:14

本文选题：晕厥 + 昼夜节律　；参考：《中国循环杂志》2017年02期

【摘要】：目的:探讨神经介导性晕厥(NMS)发作的昼夜节律。方法:选择2013-12至2015-04期间在中南大学湘雅二医院晕厥专科门诊就诊或住院的NMS患者411例,其中青少年(18岁)患者262例(63.7%),男性165例,女性246例,年龄3~68岁,平均年龄(20.95±15.20)岁。根据直立倾斜试验(HUTT)结果分为HUTT阳性组(n=281)和HUTT阴性组(n=130),详细询问患者或监护人既往晕厥发作的次数及每次发作的时间段(将1天分为4个时间段:上午06:00 am~12:00 am,下午12:00 am~18:00 pm,晚上18:00 pm~24:00 pm,夜间00:00 am~06:00 am)。结果:(1)一般资料:411例患者中晕厥发作总次数1 085次。HUTT阳性组晕厥总次数753次;HUTT阴性组晕厥总次数332次。HUTT阳性组和HUTT阴性组在性别上差异无统计学意义(P0.05),HUTT阳性组年龄低于HUTT阴性组(P0.05);(2)各时间段晕厥发作频次差异:全部患者的晕厥多发生在06:00 am~12:00 am,与其他时间段比较差异有统计学意义(P均0.05)。HUTT阳性患者的晕厥发作主要在06:00 am~12:00 am,与其他时间段比较差异有统计学意义(P均0.05);HUTT阴性组晕厥发作亦多见于06:00 am~12:00 am,但与其他各时间段比较差异无统计学意义(P0.05);HUTT阳性组与HUTT阴性组的各时间段晕厥发作频次比较差异未见统计学意义(P0.05);HUTT阳性组中,不同反应类型(直立性低血压和直立性高血压除外)患者在不同时间段晕厥发作次数差异未见统计学意义(P0.05);(3)性别与年龄差异:6:00 am~12:00 am发生晕厥男性多于女性,18:00 pm~24:00 pm发生晕厥男性少于女性(P0.05);年龄越小,6:00 am~12:00 am发生晕厥频次越多;年龄越大,00:00 am~06:00 am发生晕厥频次越多(P0.001)。结论:晕厥发作存在昼夜节律。晕厥发作主要发生在6:00 am~12:00 am,晕厥在一天4个时间段内的发作频次存在性别和年龄差异。
[Abstract]:Objective: to investigate the circadian rhythm of neuro-mediated syncope (NMS) attacks. Methods: from 2013-12 to 2015-04, 262 NMS patients (165 males and 246 females, aged 18 years) with syncope in Xiangya second Hospital of Central South University were selected. The average age was 20.95 卤15.20 years old. According to the results of the vertical tilt test, the patients were divided into HUTT positive group and HUTT negative group. The patients or guardians were asked about the number of previous syncope seizures and the time period of each episode (the first day was divided into four periods: 06:00 am~12:00 amm, below). At 12:00 am~18:00 pm, 18:00 pm~24:00 pm, 00:00 am~06:00 amm. Results the total number of syncope attacks in the positive group of Hutt was 1 085. The total number of syncope in Hutt positive group was 753 times. The total number of syncope in Hutt negative group was 332. Hutt positive group and HUTT negative group were not significantly different in sex. The frequency of syncope occurred at 06:00 in all patients with syncope at 06:00 am~12:00 amm. Compared with other time periods, the syncope seizures of the patients with positive 0.05).HUTT were mainly at 06:00 am~12:00 amm, and compared with other time periods, the frequency of syncope was significantly higher in all the patients with negative 0.05).HUTT (P < 0.05). The frequency of syncope in all the patients was significantly higher than that in the control group (P < 0.05). There were significant differences in other time periods (P < 0.05). The syncope seizures in the negative group were also found at 06:00 am~12:00 amm, but there was no significant difference between the two groups in the frequency of syncope attack in the positive group and the negative group of HUTT. There was no statistical difference between the two groups. Different types of response (except orthostatic hypotension and orthostatic hypertension) there was no significant difference in the number of syncope episodes at different time periods (P 0.05). Sex and age differences were found between males and females: 6: 00 am~12:00 am syncope occurred in males and 18: 00 pm~24:00 pm in females. The incidence of syncope in males was less than that in females, and the frequency of syncope at 6: 00 am~12:00 am was higher than that in females. The older the age is, the greater the frequency of syncope at 00: 00 am~06:00 am is (P 0.001). Conclusion: there is circadian rhythm in syncope. The onset of syncope occurred mainly at 6:00 am~12:00 am, and there were gender and age differences in the frequency of syncope within 4 periods of the day.
【作者单位】：中南大学湘雅二医院儿童医学中心儿童心血管专科中南大学儿科学研究所;
【基金】：湖南省发展改革委员会课题[湘财企指(2015)83号] 湖南省自然科学基金(2016JJ2167)
【分类号】：R54

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