儿童和成人血管迷走性晕厥的临床特征差异  

Clinical characteristics in adults and children with vasovagul syncope

作　　者：薛小红[1] 王成[1] 李茗香[1] 林萍[1] 丁异熠[1] 刘晓燕[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：《中华心血管病杂志》2008年第4期323-326,共4页Chinese Journal of Cardiology

基　　金：湖南省科技厅资助项目（06SK3036）;“十五”国家科技攻关计划资助项目（2004BA720A10）

摘　　要：目的探讨血管迷走性晕厥（VVS）的临床特征在儿童和成人之间的差异。方法分析255例经直立倾斜试验（HUTT）诊断为VVS的儿童[男50例，女86例，平均年龄（12．3±2．6）岁]和成人[男29例，女90例，平均年龄（36．4±14．0）岁]的晕厥诱因和先兆症状等，比较不同年龄段（〈18岁及≥18岁）的VVS患者在性别、HUTT方式及晕厥发作时间等方面的差异。结果（1）男女比例：儿童组为1：1．7，成人组为1：3．1，女性比例成人组高于儿童组（P=0．033）。（2）VVS先兆症状：胸闷发生率成人组高于儿童组[45．4％（54／119）比27．2％（37／136），P=0．003]，头痛[10．9％（13／119）比20．6％（28／136），P=0．036]及腹痛发生率成人组低于儿童组[7．6％（9／119）比19．1％（26／136），P=0．008]。（3）VVS发生诱因：成人组环境闷热[22．8％（26／114）比12．5％（17／136），P=0．032]和排尿晕厥发生率[9．7％（11／114）比1．5％（2／136），P=0．004]高于儿童组。（4）HUTT反应时间：舌下含化硝酸甘油倾斜试验（SNHUT）阶段混合型的平均反应时间成人组较儿童组延长[（5．04±2．27）min比（3．50±1．24）min，P=0．036]。结论成人VVS胸闷发生率、因环境闷热和排尿晕厥发生率高于儿童，头痛及腹痛发生率儿童高于成人，成人混合型平均反应时间较儿童延长。VVS临床特衍的年龄善导右卧千临床诊治．Objective To analyze the clinical characteristics in adults and children with vasovagal syncope （VVS）. Methods Clinical data including head-up tilt table （HUTT） results were analyzed and compared in 136 children （mean age 12.3 ±2.7 years, 50 boys, 86 girls） and 119 adults （mean age 36.4 ± 14. 0 years, 29 men, 90 women） with VVS. Results （ 1 ） There were more female VVS patients in adults group than that in children group （male and female ratio： children group 1：1.7 and adults group 1： 3.1, P=0. 033） in this cohort. （2）The incidence of chest distress in adults group was significantly higher than that in children group [ 45.4 （ 54/119 ） vs. 27.2% （ 37/136 ）, P = 0. 003 ] while the incidence of headache [ 10.9% （13/119） vs. 20.6% （28/136）, P = 0. 036 ] and abdominal pain in children group was significantly higher than that in adults group [ 7. 6% （ 9/119 ） vs. 19. 1% （ 26/136 ）, P = 0. 008 ]. （ 3 ） Incidences of muggy environment [ 22. 8% （ 26/114 ） vs. 12. 5 % （ 17/136 ）, P = 0. 032 ] and urination VVS [9. 7% （11/114） vs. 1.5% （2/136）, P = 0. 004] were significantly higher in adults group than those in children group. （4）The mean time of mixed response vasogal episode in adults group was significantly longer than that in children group in sublingual nitroglycerin head-up tilt table test （SNHUT） stage （ 5.04 ± 2. 27 min vs. 3.50 ± 1.24 min,P = 0. 036 ）. Conchlsions The incidences of chest distress, muggy environment and urination VVS were more often and the mean time of vasogal episode of mixed response in SNHUT stage was longer in adults VVS while the incidence of abdominal pain and headache was higher in children VVS patients compared to adults VVS patients.

关 键 词：晕厥 血管迷走神经性 儿童 成年人 临床特征 

分 类 号：R686[医药卫生—骨科学]