Caneschi A, Colzi L, Gori S S, Buccheri A M, Lagi A
Istituto di Medicina interna, Ospedale S. Maria Nuova, Firenze.
Recenti Prog Med. 1991 Sep;82(9):449-51.
Our aim was to assess the incidence and clinical characteristics of carotid sinus hypersensitivity in a group of subjects suffering from syncope. The total number of patients was 118. Twenty-four of them (20%) were diagnosed as epileptics (first attack) and 38 (32%) as vasodepressors. 56 patients with unexplained syncope underwent carotid sinus massage during electrocardiographic registration and pressure monitoring. 41 patients were found to have carotid sinus hypersensitivity. 34 of these 41 patients received implantation of a pacemaker. Abnormal sinus node function was noted in 30, abnormal atrioventricular node function in 3 and combined abnormal sinus node and AV node function in 1. Furthermore three other patients who were negative to massage were implanted with a pacemaker because they had an organic heart disease and recurrent syncope. Different tests as 24-hour monitoring ecg and electrophysiologic study showed no better results in the diagnosis of syncope. Our data demonstrates the diagnostic importance of carotid sinus massage in the diagnosis of syncope. The validity of this method is confirmed by the 24 month follow-up.
我们的目的是评估一组晕厥患者中颈动脉窦过敏的发生率和临床特征。患者总数为118例。其中24例（20%）被诊断为癫痫（首次发作），38例（32%）为血管迷走性晕厥。56例不明原因晕厥患者在心电图记录和血压监测期间接受了颈动脉窦按摩。发现41例患者存在颈动脉窦过敏。这41例患者中有34例接受了起搏器植入。其中30例存在窦房结功能异常，3例存在房室结功能异常，1例同时存在窦房结和房室结功能异常。此外，另外3例按摩结果为阴性的患者也植入了起搏器，因为他们患有器质性心脏病且反复晕厥。24小时动态心电图监测和电生理研究等不同检查在晕厥诊断中并未显示出更好的结果。我们的数据证明了颈动脉窦按摩在晕厥诊断中的重要性。24个月的随访证实了该方法的有效性。
