發(fā)布時間：2018-04-26 23:14

  本文選題：暈厥 + 晝夜節(jié)律　； 參考：《中國循環(huán)雜志》2017年02期

【摘要】：目的:探討神經(jīng)介導性暈厥(NMS)發(fā)作的晝夜節(jié)律。方法:選擇2013-12至2015-04期間在中南大學湘雅二醫(yī)院暈厥�？崎T診就診或住院的NMS患者411例,其中青少年(18歲)患者262例(63.7%),男性165例,女性246例,年齡3~68歲,平均年齡(20.95±15.20)歲。根據(jù)直立傾斜試驗(HUTT)結果分為HUTT陽性組(n=281)和HUTT陰性組(n=130),詳細詢問患者或監(jiān)護人既往暈厥發(fā)作的次數(shù)及每次發(fā)作的時間段(將1天分為4個時間段:上午06:00 am~12:00 am,下午12:00 am~18:00 pm,晚上18:00 pm~24:00 pm,夜間00:00 am~06:00 am)。結果:(1)一般資料:411例患者中暈厥發(fā)作總次數(shù)1 085次。HUTT陽性組暈厥總次數(shù)753次;HUTT陰性組暈厥總次數(shù)332次。HUTT陽性組和HUTT陰性組在性別上差異無統(tǒng)計學意義(P0.05),HUTT陽性組年齡低于HUTT陰性組(P0.05);(2)各時間段暈厥發(fā)作頻次差異:全部患者的暈厥多發(fā)生在06:00 am~12:00 am,與其他時間段比較差異有統(tǒng)計學意義(P均0.05)。HUTT陽性患者的暈厥發(fā)作主要在06:00 am~12:00 am,與其他時間段比較差異有統(tǒng)計學意義(P均0.05);HUTT陰性組暈厥發(fā)作亦多見于06:00 am~12:00 am,但與其他各時間段比較差異無統(tǒng)計學意義(P0.05);HUTT陽性組與HUTT陰性組的各時間段暈厥發(fā)作頻次比較差異未見統(tǒng)計學意義(P0.05);HUTT陽性組中,不同反應類型(直立性低血壓和直立性高血壓除外)患者在不同時間段暈厥發(fā)作次數(shù)差異未見統(tǒng)計學意義(P0.05);(3)性別與年齡差異:6:00 am~12:00 am發(fā)生暈厥男性多于女性,18:00 pm~24:00 pm發(fā)生暈厥男性少于女性(P0.05);年齡越小,6:00 am~12:00 am發(fā)生暈厥頻次越多;年齡越大,00:00 am~06:00 am發(fā)生暈厥頻次越多(P0.001)。結論:暈厥發(fā)作存在晝夜節(jié)律。暈厥發(fā)作主要發(fā)生在6:00 am~12:00 am,暈厥在一天4個時間段內的發(fā)作頻次存在性別和年齡差異。
[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 鹵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.
【作者單位】： 中南大學湘雅二醫(yī)院兒童醫(yī)學中心兒童心血管�？浦心洗髮W兒科學研究所;
【基金】：湖南省發(fā)展改革委員會課題[湘財企指(2015)83號] 湖南省自然科學基金(2016JJ2167)
【分類號】：R54

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本文編號：1808108