Colman N, Nahm K, Ganzeboom K S, Shen W K, Reitsma J, Linzer M, Wieling W, Kaufmann H
Dept. of Internal Medicine, Room F4-221 Academic Medical Centre, P.O. Box 22700, 1100 DEAmsterdam, The Netherlands.
Clin Auton Res. 2004 Oct;14 Suppl 1:9-17. doi: 10.1007/s10286-004-1003-3.
Cost-effective diagnostic approaches to reflex syncope require knowledge of its frequency and causes in different age groups. For this purpose we reviewed the available literature dealing with the epidemiology of reflex syncope. The incidence pattern of reflex syncope in the general population and general practice is bimodal with peaks in teenagers and in the elderly. In the young almost all cases of transient loss of consciousness are due to reflex syncope. The life-time cumulative incidence in young females ( congruent with 50 %) is about twice as high as in males ( congruent with 25 %). In the elderly, cardiac causes, orthostatic and postprandial hypotension, and the effects of medications are common, whereas typical vasovagal syncope is less frequent. In emergency departments, cardiac causes and orthostatic hypotension are more frequent especially in elderly subjects. Reflex syncope, however, remains the most common cause of syncope, but all-cause mortality in subjects with reflex syncope is not higher than in the general population. This knowledge about the epidemiology of reflex syncope can serve as a benchmark to develop cost-effective diagnostic approaches.
针对反射性晕厥的经济高效诊断方法需要了解其在不同年龄组中的发生率和病因。为此，我们回顾了有关反射性晕厥流行病学的现有文献。反射性晕厥在普通人群和一般医疗实践中的发病模式呈双峰型，在青少年和老年人中出现峰值。在年轻人中，几乎所有短暂性意识丧失病例都归因于反射性晕厥。年轻女性的终生累积发生率（约为50%）约为男性（约为25%）的两倍。在老年人中，心脏病因、体位性和餐后低血压以及药物作用较为常见，而典型的血管迷走性晕厥则较少见。在急诊科，心脏病因和体位性低血压更为常见，尤其是在老年患者中。然而，反射性晕厥仍然是晕厥最常见的病因，但反射性晕厥患者的全因死亡率并不高于普通人群。关于反射性晕厥流行病学的这些知识可作为制定经济高效诊断方法的基准。
