直立倾斜试验对儿童血管迷走性晕厥反复发作的预测  

Prediction with recurrent syncope in children of vasovagal syncope through head-up tilt table test

作　　者：王成[1] 何芝香[2] 李茗香[1] 薛小红[1] 郑慧芬[1] 林萍[1] 曹闽京[1] 刘晓燕[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：《中国实用儿科杂志》2007年第1期39-42,共4页Chinese Journal of Practical Pediatrics

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

摘　　要：目的探讨直立倾斜试验(HUTT)对儿童血管迷走性晕厥(VVS)反复发作的预测价值。方法2001-01—2006-08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患儿251例,男112例,女139例,年龄418(12.25±3.27)岁。依临床晕厥发生频次分A组(晕厥发作仅1次,n=54)、B组(晕厥发作24次,n=137)与C组(晕厥发作≥5次,n=60)。HUTT在取得知情同意后采用基础直立倾斜试验(BHUT,n=251)及舌下含服硝酸甘油倾斜试验(SNHUT,n=92)。结果(1)HUTT阳性率与晕厥频次关系:BHUT阳性率随晕厥频次增加而递增(χ2=4.285,P>0.05),SNHUT阳性率与晕厥频次不呈线性关系(χ2=1.316,P>0.05),HUTT总阳性率(指BHUT阳性率+SNHUT阳性率)亦随晕厥频次增加而递增(χ2=3.809,P>0.05)。(2)HUTT反应类型与晕厥频次关系:无论是BHUT还是SNHUT,反应类型以血管抑制型为主,BHUT或SNHUT在不同晕厥频次组间比较无明显差异(分别为χ2=3.008,P>0.05;χ2=2.426,P>0.05)。结论HUTT与儿童VVS临床晕厥反复发作频次无明显关系,对儿童VVS临床反复晕厥发作没有预测价值。Objective To probe prediction of recurrent syncope in children with vasovagal syncope （ VVS ） through head-up tilt table test （HUTT）. Methods There were 251 （ male 112 and female 139） patients with unexplained syncope （UPS） aged from 4 to 18 （ 12.25±3.27 ） years old who came from syncope department and hospitalization of the Second Xiangya Hospital of Central South University and they were made basic head-up tilt table test （ BHUT, n = 251 ） with power tilt table. Negative cases of BHUT were given written informed consent and then given sublingual glyceryl trinitrate 0. 2mg and made sublingual nitroglycerin head-up tilt table test （SNHUT, n =92）. The patients were divided into three groups： A group （ n =54,syncope episode only 1 time） and B group （ n = 137,syncope episode were 2 to4 times）and C group （ n = 60, syncope episode t〉 5 times ）. These data were statistically analyzed by computer with SPSS 11.0 software. Results （ 1 ） The relationship between the positive rate of HUTT and the syncope frequency： the positive rate of BHUT was increasing with the increase of syncope frequency （χ^2 =4. 285, P 〉0. 05 ） ,while the positive rate of SNHUT has no linear relation with the increase of syncope frequency （χ^2 = 1.316, P 〉 0. 05 ）, and it was also increasing with the increase of syncope frequency about the total positive rate of HUTT （ BHUT ＋ SNHUT） in different groups（χ^2 = 3. 809, P 〉0. 05）. （2）The relationship between the reaction type and the syncope frequency： the reaction type was mainly vasoinhibition beth in BHUT and SNHUT;there was no significant difference among different syncope frequency groups in BHUT（χ^2=3.008, P 〉0.05） and in SNHUT（χ^2 = 2. 426, P 〉 0. 05 ）. Conclusion There is no relationship between HUTT and recurrent syncope episodes. The positive rate of HUTT cannot predict recurrent syncope episodes in children with VVS.

关 键 词：血管迷走性晕厥 反复晕厥 倾斜台试验 儿童 诊断 

分 类 号：R72[医药卫生—儿科]