作者：王慧芳，黄织春

单位：

内蒙古医科大学附属医院心血管内科

Units：

Department of Cardiology, the Affiliated Hospital of Inner Mongolia Medical University;

关键词：

晕厥,血管迷走神经性; 心室复极化; 腺苷; 综述;

Keywords：

Syncope,vasovagal;Ventricular repolarization;Adenosine;Review;

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.289

Funds：

内蒙古自治区科技计划项目（201802112）；

摘要：

晕厥是临床上常见的症状，其中又以血管迷走性晕厥最为常见。引发晕厥的病因很多，其机制复杂，主要与自主神经功能障碍有关。直立倾斜试验是目前诊断血管迷走性晕厥的“金标准”，已被广泛应用于临床科室。心电图检查应用广、价格低，可发现具体或潜在的晕厥原因，是对晕厥进行初步评估的有效方法之一。正常心肌细胞电活动包括去极化和复极化，其中复极化过程尤为重要，而自主神经通过对离子通道的控制影响复极化过程，自主神经张力增高或减低均会对心室复极化产生影响。除此之外，血浆腺苷水平作为重要的生化指标对血管迷走性晕厥的诊断亦起着至关重要的作用。本文通过回顾相关文献，重点分析了直立倾斜试验期间心室复极化指标[包括QT间期（QT）、校正QT间期（QTc）、QT间期离散度（QTd）、T波峰-末间期（Tp-Te）、Tp-Te/QT、Tp-Te/QTc、JT间期、校正JT间期（JTc）、JT间期离散度（JTd）、JT延长指数（JTI）]、血浆腺苷水平与血管迷走性晕厥的关系。

Abstract：

Syncope is a common clinical symptom, among which vasovagal syncope is the most common. There are many causes of syncope, and its mechanism is complex, mainly related to autonomic dysfunction. Head up tilt test is the "gold standard" for the diagnosis of vasovagal syncope at present, and has been widely used in clinical departments. Electrocardiography is widely used and inexpensive, and can find specific or potential causes of syncope, and is one of the effective methods for the initial assessment of syncope. Normal cardiomyocyte electrical activity includes depolarization and repolarization, of which the repolarization process is particularly important, while autonomic nerves affect the repolarization process through the control of ion channels, and either increased or decreased autonomic tone can affect ventricular repolarization. In addition, plasma adenosine levels, as an important biochemical marker, also play a crucial role in the diagnosis of vasovagal syncope. By reviewing the relevant literature, this paper focuses on the analysis of the relationship between ventricular repolarization indexes [including QT interval（QT）, QT interval（QT）, corrected QT interval（QTc）, QT interval dispersion（QTd）, T peak-T end interval（Tp-Te）, Tp-Te/QT, Tp-Te/QTc, JT interval, corrected JT interval（JTc）, JT interval dispersion（JTd）, JT prolongation index（JTI） ] during head-up tilt test, plasma adenosine levels and vasovagal syncope.

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