血管迷走性晕厥患者晕厥先兆的影响因素分析 Analysis of Influencing Factors of Presyncope in Vasovagal Syncope Patients

Abstract

目的 分析血管迷走性晕厥患者的临床特点，探讨其晕厥前是否有晕厥先兆的影响因素。 方法 回顾性纳入2017年1月—2022年6月首都医科大学附属北京天坛医院诊治的血管迷走性晕厥患者为研究对象。采集其一般资料、直立倾斜试验结果及血流动力学指标，采用多因素logistic回归分析探讨患者发生晕厥先兆的影响因素。 结果 研究共纳入血管迷走性晕厥患者1211例。根据其发生晕厥前是否有先兆症状进行分组，其中无先兆组582例（48.06%），有先兆组629例（51.94%）。有先兆组患者的年龄（t=6.006，P<0.001）、女性比例（χ2=11.749，P=0.001）、BMI（t=2.562，P=0.011），以及既往有高血压（χ2=12.643，P<0.001）、糖尿病（χ2=9.129，P=0.003）、脑血管病（χ2=4.060，P=0.044）的比例与无先兆组比较，差异有统计学意义。两组患者直立倾斜试验结果比较差异无统计学意义（χ2=6.205，P=0.102）。多因素logistic回归分析发现，年龄≤60岁（OR=1.727，95%CI 1.347～2.214，P<0.001）和女性（OR=1.440，95%CI 1.122～1.847，P=0.004）是血管迷走性晕厥患者发生晕厥先兆的危险因素。 结论 年龄≤60岁和女性血管迷走性晕厥患者更易发生晕厥先兆，这可能与自主神经调节功能有关。 Abstract: Objective To analyze the clinical characteristics of vasovagal syncope patients and to discuss if they exhibit factors affecting the existence of presyncope. Methods Patients with vasovagal syncope admitted to Beijing Tiantan Hospital, Capital Medical University from January 2017 to June 2022 were included retrospectively. Their general data, results of head-up tilt test and hemodynamic indexes were collected. Multivariate logistic regression analysis was used to explore the influencing factors of presyncope. Results A total of 1211 patients with vasovagal syncope were included in the study. The patients were divided into two groups according to the presence or absence of presyncope, with 582 (48.06%) cases in the non-presyncope group and 629 (51.94%) cases in the presyncope group. There were statistically significant differences in the following factors between the two groups: age (t=6.006, P<0.001), number of female (χ2=11.749, P=0.001), BMI (t=2.562, P=0.011), and history of hypertension (χ2=12.643, P<0.001), diabetes (χ2=9.129, P=0.003) and cerebral vascular disease (χ2=4.060, P=0.044). There was no significant difference in the results of head-up tilt test between the two groups (χ2=6.205, P=0.102). Multivariate logistic regression analysis showed that age≤60 years (OR=1.727, 95%CI 1.347-2.214, P<0.001) and being a female (OR=1.440, 95%CI 1.122-1.847, P=0.004) were the risk factors of presyncope. Conclusions Vasovagal syncope patients with≤60 years of age and female are more likely to have presyncope before syncope. This may be related to the function of autonomic nervous regulation.

Keywords

• 血管迷走性晕厥
• 晕厥先兆
• 直立倾斜试验
• 自主神经调节功能
• vasovagal syncope
• presyncope
• head-up tilt test
• autonomic nervous regulation function