Winker R, Barth A, Dorner W, Mayr O, Pilger A, Ivancsits S, Ponocny I, Heider A, Wolf C, Rüdiger H W
Division of Occupational Medicine, University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria.
Int Arch Occup Environ Health. 2003 Mar;76(2):143-50. doi: 10.1007/s00420-002-0395-4. Epub 2002 Oct 30.
Orthostatic intolerance (OI) is a syndrome that is characterised by headache, concentration difficulties, palpitation of the heart, dizziness associated with postural tachycardia and plasma norepinephrine concentrations that are disproportionately high when the sufferer is in the upright posture. In contrast to other forms of orthostatic dysregulation - orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS) - OI, hitherto, could be diagnosed only by a tilt table examination, with high expenditure. In this paper we examine the reliability and validity of a questionnaire as a screening instrument for OI.
We studied 138 young men (mean age 21.6 years) who were undergoing military service. After a medical check and filling in the questionnaire, the participants underwent a tilt table test including monitoring of blood pressure, heart rate and plasma catecholamines, in the supine position and during 30 min of standing. The questionnaire consisted of ten items registering presence and frequency of typical OI symptoms.
Probands (104) showed normal tilt table test results. OI was diagnosed in 14 probands, OH in 6 and POTS in 14. The OI participants scored significantly higher in the questionnaire than the healthy subjects did: the mean score of the OI group was 22.6, the healthy participants had a mean score of 3.9. Participants with POTS had a mean score of 13.5 and subjects with OH had a mean score of 17.0. Reliability analysis showed a Cronbach's alpha of 0.888. Validity analysis showed that 93.5% of the probands with any kind of orthostatic dysregulation can be detected.
We were able to establish a short questionnaire as a reliable and valid screening instrument for OI. Usage of this questionnaire can simplify enormously the diagnostic management of patients with suspected OI.
直立不耐受（OI）是一种综合征，其特征为头痛、注意力难以集中、心悸、与体位性心动过速相关的头晕，以及患者直立时血浆去甲肾上腺素浓度异常升高。与其他形式的直立性调节障碍——直立性低血压（OH）和体位性直立性心动过速综合征（POTS）不同——迄今为止，OI仅能通过倾斜试验来诊断，成本较高。在本文中，我们检验了一份问卷作为OI筛查工具的可靠性和有效性。
我们研究了138名正在服兵役的年轻男性（平均年龄21.6岁）。在进行医学检查并填写问卷后，参与者接受了倾斜试验，包括在仰卧位和站立30分钟期间监测血压、心率和血浆儿茶酚胺。问卷由十个项目组成，记录典型OI症状的存在情况和频率。
先证者（104名）倾斜试验结果正常。14名先证者被诊断为OI，6名被诊断为OH，14名被诊断为POTS。OI参与者在问卷中的得分显著高于健康受试者：OI组的平均得分为22.6分，健康参与者的平均得分为3.9分。POTS参与者的平均得分为13.5分，OH受试者的平均得分为17.0分。可靠性分析显示Cronbach's α系数为0.888。有效性分析表明，93.5%的任何类型直立性调节障碍的先证者都能被检测出来。
我们能够制定一份简短的问卷，作为OI可靠且有效的筛查工具。使用这份问卷可以极大地简化疑似OI患者的诊断管理。
