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目的了解异丙肾上腺素静脉滴注在直立倾斜试验中的应用剂量和价值。方法对63例疑似血管迷走性晕厥且基础直立倾斜试验阴性的患儿静脉滴注异丙肾上腺素,5 min后再倾斜到原来的角度,并持续给药10 min或直至出现阳性反应。滴注剂量分别为:第一阶段0.02~0.04μg.kg-1.min-1,第二阶段0.04~0.06μg.kg-1.min-1,第三阶段0.06~0.08μg.kg-1.min-1。3个阶段方法及步骤均一致。结果 63例患儿中37例出现阳性反应。第一阶段9例出现阳性反应,第二阶段23例出现阳性反应,第三阶段5例出现阳性反应。37例阳性反应的患儿中21例为血压依赖型,13例为心率依赖型,3例为混合依赖型。在第二阶段中出现阳性反应的患儿占所有阳性患儿的62%,其剂量为0.04~0.06μg.kg-1.min-1时阳性率最高。结论异丙肾上腺素静脉滴注在直立倾斜试验中有较高的应用价值。
Objective To investigate the dose and value of intravenous isoproterenol infusion in upright tilt test. Methods Sixty-three children with suspected vasovagal syncope and a negative basal tilt test were infused intravenously with isoproterenol. After 5 minutes, they were re-tilted to the original angle and continued for 10 minutes or until a positive reaction was observed. The instillation doses were 0.02-0.04 μg.kg-1.min-1 in the first phase, 0.04-0.06 μg.kg-1.min-1 in the second phase, and 0.06-0.08 μg.kg-1 in the third phase. min-1.3 steps and steps are the same. Results 63 cases of children in 37 cases appeared positive reaction. In the first stage, 9 cases showed a positive reaction, the second stage showed positive reaction in 23 cases, and the third stage showed positive reaction in 5 cases. Of the 37 positive children, 21 were blood pressure-dependent, 13 were heart-rate-dependent, and 3 were mixed-dependent. The positive reaction in the second stage of children accounted for 62% of all positive children, the dose of 0.04 ~ 0.06μg.kg-1.min-1, the highest positive rate. Conclusion Isoproterenol intravenous infusion in the tilt test has high application value.