不同角度直立倾斜试验对儿童血管迷走性晕厥诊断的影响  

Diagnostic influence of different angles of head-up tilt table test on children with vasovagal syncope

作　　者：王成[1] 何芝香[2] 李茗香[1] 曹闽京[1] 郑慧芬[1] 薛小红[1] 林萍[1] 刘洁明[1] 

机构地区：[1]中南大学湘雅二医院儿科心血管病研究室中南大学儿科学研究所,湖南长沙410011 [2]湖南省儿童医院呼吸免疫科,湖南长沙410007

出　　处：《中国急救医学》2006年第6期411-414,共4页Chinese Journal of Critical Care Medicine

基　　金："十五"国家科技攻关计划项目(No.2004BA720A10);湖南省科技厅资助项目(No.03SSY4022)

摘　　要：目的 探讨不同角度直立倾斜试验（HUTT）对儿童血管迷走性晕厥（VVS）诊断的影响。方法 2001—01—2005—12在中南大学湘雅二医院晕厥专科门诊就诊或住院的儿童不明原因晕厥（UPS）患者进行HUTT检查226例次，年龄4-18岁，平均（12．12±3．17）岁，男93例，女133例。倾斜角度在2001—01—2005—05采用70°[n=182，平均（12．19±3．20）岁]，在2005—06-2005—12采用60°[n=44，平均（11．82±3．02）岁]。根据临床症状分偶发晕厥（n=66，晕厥发作仅1次）与反复晕厥（n=160，晕厥发作≥1次）。HUTT采用基础直立倾斜试验（BHUT）及舌下含服硝酸甘油倾斜试验（SNHUT）。结果 倾斜角度、儿童患者性别及试验方式对UPS儿童血流动力学无影响（P〉0．05），UPS儿童诊断阳性率及反应类型分布与倾斜角度、儿童患者性别、试验方式及晕厥频次亦无明显关系（P〉0．05）。儿童倾斜70°体位感到欠舒适，倾斜60°体位无明显不适感。结论 倾斜70°和60°对受试者血流动力学及阳性率无影响，倾斜60°体位较70°感到舒适。推荐临床上在进行儿童HUTT时选择倾斜60°较合适。Objective To explore diagnostic influence of different angles of head- up tilt table test （HUTT） on children with vasovagai syncope （VVS）. Methods There were 226 （male 93 and female 133） patients of unexplained syncope （UPS） aged from 4 to 18 years old [mean （ 12.12 ± 3.17 ）years] who came from syncope department and hospitalization of the Second Xiangya Hospital of Central South University during Jan 2001 to Dec 2005 and made basic head - up tilt table test （BHUT） with power tilt table. Negative cases of BHUT were given sublingual glyceryl trinitrate 0.2 mg and made sublingual nitroglycerin head - up tilt table test （SNHUT）. The tilt test angle was 70°（ n = 182） during Jan 2001 to May 2005 and 60°（ n = 44） during June 2005 to Dec 2005. The patients were divided into occasional syncope group （ n = 66, syncope episode only 1 time） and recurrent syncope group （ n = 160, syncope episode≥ 1 time）. These data were statistiesed by computer with SPSS 11.0 software. Results The tilt test angle and gender of children and test mode were not relation to the hemodynamics of patients （ P 〉 0.05）. The positive rate and reaction type had nothing to do with the tilt test angle and gender of children and test mode and frequency of syncope（ P 〉 0.05）. The children felt more comfortable in tilt angle 60° than in 70°. Conclusionn The tilt test angle of 60° and 70° don＇ t affect the positive rate of HUTT and the hemodynamics in children with VVS. The children feel more comfortable in tilt angle 60° than in 70°. The 60° tilt angle of HUTF in children is recommended in clinic.

关 键 词：血管迷走性晕厥 倾斜台试验 倾斜角度 儿童 

分 类 号：R725.4[医药卫生—儿科]