Lörincz I, Fontaine J M
Division of Cardiology, Medical College of Pennsylvania.
Orv Hetil. 1995 Apr 16;136(16):827-32.
71 patients with unexplained syncope was examined by 60 grade of head up tilt table test with or without administration of isoproterenol during 25 minutes interval. The mean age of patients was 71.44 +/- 16.40 (12-86) years. 38 (54%) were female and 33 (46%) were male. The underlying heart disease were 27 (38%) coronary artery disease, 12 (17%) arterial hypertension, 6 (8%) diabetes mellitus, 3 (4%) valvular heart disease and 14 (20%) patients had other diseases. Nine (13%) patients had no organic disease. During head up tilt table test positive reaction was found in 13 (18%) patients. Four (6%) patients were vaso-vagal syncope with classic signs, and 9 (13%) patients were vasodepressor type of syncope, without changes in the heart rate. Isoproterenol was given to 16 (23%) patients, and in 4 (6%) (2 vasodepressor and 2 mixed type of syncope) patients occurred the positive test during isoproterenol administration. Orthostatic reaction occurred during head up tilt table test in 14 (20%) patients. Normal was the result of tilt table test in 42 (59%) patients, and two (3%) patients had autonome neuropathy. The vasovagal syncope was treated by metoprolol, atenolol and disopyramid with success. The head up tilt table testing is a good, simple, useful test for evaluation of syncope patients, especially the diagnosis of vasovagal syndrome.
71例不明原因晕厥患者接受了60度头高位倾斜试验检查，在25分钟的间隔内给予或不给予异丙肾上腺素。患者的平均年龄为71.44±16.40（12 - 86）岁。女性38例（54%），男性33例（46%）。基础心脏病包括冠心病27例（38%）、动脉高血压12例（17%）、糖尿病6例（8%）、瓣膜性心脏病3例（4%），14例（20%）患者患有其他疾病。9例（13%）患者无器质性疾病。在头高位倾斜试验中，13例（18%）患者出现阳性反应。4例（6%）患者为典型体征的血管迷走性晕厥，9例（13%）患者为血管减压型晕厥，心率无变化。16例（23%）患者给予了异丙肾上腺素，其中4例（6%）（2例血管减压型和2例混合型晕厥）患者在给予异丙肾上腺素期间出现阳性试验。14例（20%）患者在头高位倾斜试验中出现直立位反应。42例（59%）患者倾斜试验结果正常，2例（3%）患者有自主神经病变。血管迷走性晕厥采用美托洛尔、阿替洛尔和丙吡胺治疗成功。头高位倾斜试验是评估晕厥患者的一种良好、简单、有用的检查方法，尤其对血管迷走性综合征的诊断有帮助。
