疑诊血管迷走性晕厥患者中直立倾斜试验阳性者的心电图特征

发布时间：2018-12-10 15:36

【摘要】：目的:探讨疑诊血管迷走性晕厥患者中直立倾斜试验阳性者的心电图特征。方法:共收集于2015-08至2016-05在中国医学科学院阜外医院门诊就诊且临床怀疑血管迷走性晕厥而接受直立倾斜试验检查的502例受试者,同步记录检查过程中的12导联心电图。根据直立倾斜试验结果分为阳性组(n=244)和阴性组(n=258),对比两组的P波时限、校正QT间期(QTc)和P波电轴。结果(:1)阳性组受试者晕厥时的P波时限较阴性组明显延长[(95.65±38.50)ms vs(88.61±17.09)ms,P0.05];(2)阳性组受试者发生晕厥前的P波电轴较阴性组明显右偏[(69.87±18.18)°vs(66.82±16.51)°,P0.05],而在晕厥时[(62.87±25.39)°vs(68.47±15.30)°]及晕厥后[(56.87±22.45)°vs(68.49±16.35)°]较阴性组明显左偏(P均0.05)(;3)阳性组受试者发生晕厥前的QTc较阴性组明显缩短[(418.69±92.35)ms vs(435.76±59.29)ms,P0.05]。结论:疑诊血管迷走性晕厥患者中直立倾斜试验阳性者有独特的心电图特征,其中P波时限、P波电轴及QTc数值对血管迷走性晕厥发作有一定的预警作用。
[Abstract]:Objective: to investigate the electrocardiographic characteristics of patients with vasovagal syncope suspected by orthostatic tilt test. Methods: from August to May 2016-05, 502 subjects who received vertical tilt test for suspected vasovagal syncope in Fuwei Hospital, Chinese Academy of Medical Sciences, were examined by orthostatic tilt test. The 12-lead electrocardiogram (ECG) was recorded simultaneously. According to the results of vertical tilt test, the patients were divided into positive group and negative group. The P wave duration was compared and the QT interval (QTc) and P wave axis were corrected. Results (1) the P wave duration in the positive group was significantly longer than that in the negative group [(95.65 卤38.50) ms vs (88.61 卤17.09 ms,P0.05)]; (2) the P wave axis before syncope in the positive group was significantly higher than that in the negative group [(69.87 卤18.18) 掳vs (66.82 卤16.51) 掳, P0.05]. In the syncope group [(62.87 卤25.39) 掳vs (68.47 卤15.30) 掳] and after syncope [(56.87 卤22.45) 掳vs (68.49 卤16.35) 掳], the left deviation was significantly higher than that in the negative group (all P 0.05) (;). 3) the QTc before syncope in the positive group was significantly shorter than that in the negative group [(418.69 卤92.35) ms vs (435.76 卤59.29) ms,P0.05]. Conclusion: the patients with suspected vasovagal syncope have unique electrocardiogram characteristics. The P wave duration, P wave axis and QTc values have some early warning effect on vasovagal syncope.
【作者单位】：北京协和医学院中国医学科学院国家心血管病中心阜外医院功能检测中心;
【分类号】：R54

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