114例女性血管迷走性晕厥患者的临床特征及转归情况分析

摘要

Objective To analyze the clinical features and outcome of 114 female patients with vasovagal syncope (VVS). Methods From May 2002 to June 2014 in Wujin Hospital Affiliated to Jiangsu University,a total of 114 female VVS patients with complete head - up tilt test(HUTT)data were enrolled,all of them received symptomatic treatment after admission and systematic health education before discharge,and they were followed up to September 2014. Age distribution,HUTT results, disease subtypes,precipitating factors before syncope,premonitory symptoms of syncope,incidence of syncope or premonitory symptoms during HUTT,clinical outcome were retrospectively analyzed. Results Age distribution:8 cases were 12 to 19 years old,4 cases were 20 to 29 years old,10 cases were 30 to 39 years old,31 cases were 40 to 49 years old,21 cases were 50 to 59 years old,28 cases were 60 to 69 years old,70 cases were equal or above years old. HUTT results:30 cases occurred positive results at basic test phase,84 cases occurred positive results at drug stimulated test phase. Disease subtypes:53 cases were vasodepressive type( accounted for 46. 5% ),12 cases were cardioinhibitory type( accounted for 10. 5% ),49 cases were mixed type(accounted for 43. 0% ). Before seeing a doctor,50 cases occurred more than once syncope attack(accounted for 43. 9% );89 cases had certain precipitating factors( accounted for 78. 1% ),and some of them had multiple precipitating factors. Chest distress,dizziness and panhidrosis were the most common symptoms in the 98 cases with premonitory symptoms of syncope( accounted for 86. 0% ). During HUTT,110 cases occurred syncope or premonitory symptoms ( accounted for 96. 5% ),thereinto 64 cases occurred 3 or more premonitory symptoms of syncope(accounted for 58. 2% ). Up to the end of follow - up,78 cases were completely followed up,thereinto 70 cases did not occur syncope,8 case occurred recurrent syncope. Conclusion Fully understanding of clinical features of female VVS patients is helpful to confirm the diagnosis as soon as possible,systematic health education can effectively prevent the incidence of tumble.%目的：分析114例女性血管迷走性晕厥（VVS）患者的临床特征及转归情况。方法选取江苏大学附属武进医院心内科2002年5月—2014年6月收治的114例女性 VVS 患者，直立倾斜试验（HUTT）检查资料完整。入院后均进行相关治疗，出院前均进行系统宣教，随访至2014年9月。回顾性分析其年龄分布情况、HUTT 检查结果、疾病分型、晕厥前诱因、晕厥先兆症状、HUTT 检查时晕厥及晕厥先兆症状、随访时转归情况。结果年龄分布：12～19岁8例、20～29 岁 4例、30～39岁10例、40～49岁31例、50～59岁21例、60～69岁28例、≥70岁12例。HUTT 检查结果：基础倾斜试验阶段阳性30例，药物激发试验阶段阳性84例。疾病分型：血管抑制型（VD 型）53例（46.5%），心脏抑制型（CI 型）12例（10.5%），混合型（MX 型）49例（43.0%）。50例（43.9%）患者就诊前晕厥发作＞1次。89例（78.1%）患者晕厥前有具体诱因，其中部分患者有多种诱因。98例（86.0%）患者有晕厥先兆症状，其中胸闷、头晕和全身出汗为最常见的3个先兆症状。110例（96.5%） 患者在行 HUTT 检查时出现晕厥或晕厥先兆症状，其中64例（58.2%）患者同时出现3种或3种以上的先兆症状。78例患者获得随访，其中70例患者未再次发生晕厥，8例患者仍有晕厥发生。结论了解女性 VVS 患者的发病特点有助于临床尽早明确诊断，且系统的宣教能有效预防 VVS 跌倒伤害事件的发生。