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기립불능증에서 기립경사 검사와 웅크림 혈압 측정의 유용성

Usefulness of Squatting Combined with the Blood Pressure Measurement for Orthostatic Intolerance in Dizziness Clinic

대한신경근육질환학회지 2020년 12권 2호 p.32 ~ 35
서호성, 김수영, 손은희, 정성해,
소속 상세정보
서호성 ( Seo Ho-Seong ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Neurology
김수영 ( Kim Soo-Young ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Neurology
손은희 ( Sohn Eun-Hee ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Neurology
정성해 ( Jeong Seong-Hae ) - Chungnam National University College of Medicine Chungnam National University Hospital Department of Neurology

Abstract


Background: Orthostatic intolerance (OI) is a common clinical symptom in dizziness clinic. The head-up tilt table test (HUT) is one of the primary clinical examination for evaluating OI. There is no consensus on the optimum method for diagnosis of orthostatic hypotension (OH). Herein, we performed the additional squat combined with blood pressure (BP) monitoring for OI patients with normal HUT.

Methods: The study included 32 consecutive patients with orthostatic intolerance for 3 months since April, 2018 (Period I) and 27 patients with orthostatic intolerance for 3 months since April, 2019 (Period II) in dizziness clinic of Chungnam National University Hospital. During Period II, the additional squat combined with BP test was performed for normal HUT results in patients with OI. In squat combined orthostatic BP measurement, the first BP measurement was taken following 3 minutes of rest at the squat position; afterwards the patients were raised upright and the measurement was monitored for 2 minutes, using a continuous beat-to-beat BP monitoring.

Results: In this study, there was significant difference in OH diagnosis (p<0.001); 40.6% (13/32) by conventional HUT (Period I) vs. 92.5% (25/33) by conventional HUT and additional squat test for normal HUT (Period II). In patients with normal HUT, the positive OH was 86.7% (13/15) by the additional squat combined BP measurement (Period II).

Conclusions: In addition to HUT, squat test combined with BP measurement might be more informative for understanding and diagnosing the OH, particularly in patients with OI and normal HUT in dizziness clinic.

키워드

Orthostatic intolerance; Tilt table test

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