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目的探讨中国人直立不耐受(OI)的性别和年龄差异。方法 2004年1月至2009年6月在中南大学湘雅二医院晕厥专科门诊就诊或住院的不明原因晕厥、头晕、胸闷、胸痛或心悸的患者1069例,年龄平均(19.22±14.80)岁(3～72岁),男506例,女563例。其中<18岁(儿童组)728例,≥18岁(成年组)341例。经常规检查排除器质性心脏病及其他疾病后行直立倾斜试验(HUTT)明确诊断。结果 (1)OI阳性率60.99%,女性大于男性;成人组与儿童组比较差异无统计学意义(P>0.05)。(2)OI类型以血管迷走性晕厥(VVS)多见,其次为体位性心动过速综合征(POTS)及直立性低血压(OH)。VVS混合型比例女性高于男性(P<0.05);心脏抑制型与OH比例在儿童组和成人组之间差异无统计学意义(P>0.05);血管抑制型和混合型比例成人组大于儿童组(P<0.05),而POTS比例则儿童组大于成人组(P<0.01)。(3)女性患者中VVS血管抑制型比例儿童组低于成人组(P<0.05),混合型比例儿童组高于成人组(P<0.01);POTS在儿童组高于成人组(P<0.01)。结论 OI阳性率不存在年龄差异,但女性高于男性。OI类型分布存在一定的年龄和性别差异。
Objective To investigate the gender and age differences of Chinese Orthostatic Intolerance (OI). Methods From January 2004 to June 2009, 1069 patients with syncope, dizziness, chest tightness, chest pain or heart palpitations were enrolled in the Syncope Specialist Outpatient Department of Xiangya Second Hospital of Central South University. The average age was (19.22 ± 14.80) years old (3 ~ 72 years old), 506 males and 563 females. Among them, 728 were children <18 years old and 341 were ≥18 years old (adult group). Routine examination excluding organic heart disease and other diseases after the straight tilt test (HUTT) a clear diagnosis. Results (1) OI positive rate of 60.99%, women than men; adults and children group was no significant difference (P> 0.05). (2) The OI type is more common with VVS, followed by POTS and OH. (P <0.05). There was no significant difference in the ratio of cardiac inhibition to OH between children and adults (P> 0.05), while those in VVS mixed and proportional mixed adults were significantly higher than those in children Group (P <0.05), while POTS ratio in children group was higher than that in adult group (P <0.01). (3) The proportion of VVS-suppressed vasculature in female group was significantly lower than that of adult group (P <0.05), the ratio of POTS was higher in adult children than in adult children (P <0.01) ). Conclusion OI positive rate does not exist age differences, but women are higher than men. OI type distribution has some age and gender differences.