血管迷走性晕厥儿童心率变异性的年龄和性别差异  

Differences between age and gender of heart rate variability in children with vasovagal syncope

作　　者：郑慧芬[1] 王成[1] 曹闽京[1] 薛小红[1] 李茗香[1] 林萍[1] 刘晓燕[1] 丁异熠[1] 胡春艳[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,长沙410011

出　　处：《中国急救医学》2007年第11期971-974,共4页Chinese Journal of Critical Care Medicine

基　　金：湖南省科技厅资助项目(No.06SK3036);"十五"国家科技攻关计划项目(No.2004BA720A10)

摘　　要：目的探讨血管迷走性晕厥(VVS)儿童心率变异性(HRV)的年龄和性别差异。方法2003—01～2007—05在中南大学湘雅二医院晕厥专科诊治的不明原因晕厥(UPS)儿童54例(晕厥组),其中<12岁儿童22例,直立倾斜试验(HUTF)全部为阳性反应。匹配48例健康儿童为对照(对照组)。晕厥组和对照组儿童均行24 h动态心电图(Holter)检查,数据经TLC3000A 12通道动态心电图分析系统自动分析结合人工干预生成HRV时域指标和频域指标。结果①晕厥儿童HRV性别比较:与男性儿童相比,女性儿童各项时域指标和频域指标均偏低,其中时域指标总体标准差(SDNN)、均值标准差(sDANN)和频域指标总功率(TP)、低频功率(LF)、极低频功率(VLF)降低显著(P<0.01或P<0.05)。②健康儿童HRV性别比较:女性儿童时域指标SDNN、差值均方根(rMSSD)、差值>50 ms的百分比(pNN50)和频域指标TP、VLF、LF低于男性儿童,其中差异有统计学意义的是频域指标VLF(P<0.01)和LF(P<0.05)。③晕厥儿童HRV年龄比较:与≥12岁儿童相比,<12岁儿童时域指标SDNN、SDANN、pNN50和频域指标TP、LF稍降低(均P>0.05)。④健康儿童HRV年龄比较:与≥12岁儿童相比,<12岁儿童时域指标rMSSD、pNN50和频域指标LF、高频功率(HF)偏高,其中差异有统计学意义的是HF(P<0.05),其余指标稍偏低(均P>0.05)。结论VVS儿童自主神经功能异常,其自主神经变化规律的年龄和性别差异与健康儿童不同。Objective To explore the differences between age and gender of heart rate variability （HRV） in children with vasovagal syncope （ VVS ）. Methods Fifty - four children with unexplained syncope [ 17 males, 37 females, aged 6 ~ 17 years old, mean （ 11.59 ± 2.28 ） years old] were enrolled in this study and were positive in head- up tilt table test （HUTr）. Among them, 22 were less than 12 years and 48 healthy children were matched as controls. 24 - hour dynamic electrocardiogram （Holter） was performed in all the children and Hoher recordings were analyzed in the computer. SPSS 11.0 software was used for the statistical analysis of these data. Results Compared with males, SDNN, TP, LF （ P 〈0.01 ） and SDANN, VLF （ P 〈 0.05 ） of females were significantly lower and other indexes were slightly lower （P 〉 0.05） in syncope group. SDNN, rMSSD, pNN50 and TP, VLF, LF were lower in females than males, but only VLF （ P 〈 0.01 ） and LF （ P 〈 0.05 ） were significant in control group. SDNN, SDANN, pNN50 and TP, LF were slightly lower （P 〉0.05） in 22 children 〈 12 years old than the others in syncope group. Compared with syncope group, control group showed different changes. HF was significantly higher （ P 〈 0.05 ） in 22 children 〈 12 years old than the others. Conclusions The autonomic function is abnormal in children with VVS. The differences between age and gender of autonomic profile in children with VVS are different from healthy children.

关 键 词：血管迷走性晕厥 心率变异性 儿童 年龄 性别 

分 类 号：R725.4[医药卫生—儿科]