本文選題：咳嗽性暈厥 + 直立傾斜試驗��； 參考：《重慶醫(yī)學》2017年28期

【摘要】：目的探討直立傾斜試驗(HUT)對咳嗽性暈厥(CS)的診斷價值。方法選取2011年1月至2016年5月該院門診或住院CS患者47例作為觀察組,同期有暈厥史的擬診為血管迷走性暈厥(SVVS)的患者79例為對照組。兩組均行HUT,觀察HUT中咳嗽反應,咳嗽引發(fā)收縮壓、舒張壓及心率變化,HUT陽性結果及血流動力學類型。結果觀察組患者咳嗽誘發(fā)暈厥4例(8.51%),暈厥先兆26例(55.32%),無癥狀17例(36.17%),對照組79例(100.00%)均無癥狀,差異有統(tǒng)計學意義(P0.05)。觀察組咳嗽反應總陽性率為63.83%,特異性為100.00%。各組患者收縮壓比較差異均有統(tǒng)計學意義(P0.05)。觀察組無癥狀者舒張壓與觀察組暈厥者、觀察組暈厥先兆者比較差異有統(tǒng)計學意義(P0.05),與對照組無癥狀者比較差異無統(tǒng)計學意義(P0.05)。各組心率比較差異無統(tǒng)計學意義(P0.05)。觀察組患者HUT陽性率低于對照組(P0.05),兩組間血流動力學類型差異均無統(tǒng)計學意義(P0.05)。結論 HUT中劇烈咳嗽可引起CS患者血壓下降,誘發(fā)暈厥或暈厥先兆,能提高CS患者診斷的敏感性,對懷疑診斷為CS的患者,尤其是病史不清的CS患者的診斷是十分有益的。
[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.
【作者單位】： 河南省人民醫(yī)院心功能科;
【基金】：河南省科學技術廳科技攻關基金資助項目(152102310419)
【分類號】：R741.04

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