【摘要】 目的探讨无晕厥病史患者出现的直立性T波改变的发生机理及其与血管迷走性晕厥的相关性;方法利用活动平板运动试验初筛出直立性T波改变预检患者,经基础倾斜试验进一步确证,再行硝酸甘油倾斜试验。第2天,阳性患者经随机分组,双盲对照服用安慰剂(=22)或30mg普荼各尔(=21)60min后重复基础倾斜试验、硝酸甘油倾斜试验。结果100例直立性T波改变患者在基础倾斜试验中无1例阳性反应,在随后的NTTT中有43例出现阳性结果。第2天,安慰剂组直立性T波改变及NTTT阳性有比率明显高于普荼各尔组(依次为86.4%∶23.8%,P<0.01,72.7%∶28.6%,P<0.01)。结论直立性T波改变是人体由卧位到立位引起神经-体液变化所致的心室肌复极异常,它是血管迷走性晕厥形成过程中某一阶段出现的一种伴随现象,与血管迷走性晕厥有一定的相关性,心得安等β-受体阻滞剂作为首选药物来治疗直立性T波改变和伴随有直立性T波改变的血管迷走性晕厥患者,收到肯定的临床疗效。更多还原

【Abstract】 Objective To investigate the mechanism of body posture T wave inversions in patients without vasovagal syncope, and the relation between body posture T wave inversions and Vasovagal Syncope. Methods 100 patients who had body posture T wave inversions in treadmill stress tests were invited to undergo baseline tilt table testing(BTTT) and Sublingual nitrate-stimulated tilt table testing(NTTT) consequently. The next day, patients who had had a positive result in the first day’s NTTT were randomized into the propranolol group(=21) and the placebo group(=22). Then they underwent BTTT and NTTT again 1 hour after the administration of placebo or 30mg of propranolol. The results of tilt table testings were compared double blindly. Results None of the 100 patients with T wave inversions had a positive result in the first day’s BTTT. 43 of the following NTTT results were positive. The second day, after the administration of the placebo or propranolol, the rate of T wave inversion or positive NTTT result in the placebo group were significantly higher than that of the propranolol group(86.4% vs. 23.8%, P<0.01, 72.7% vs. 28.6%, P<0.01, respectively). Conclusion Body posture T wave inversions is a associated phenomenon in the generation of Vasovagal Syncope. β-blockers such as propranolol should be the first-line medicines to treat body posture T wave inversions and Vasovagal Syncope with body posture T wave inversions.更多还原