儿童不明原因胸闷和（或）胸痛与直立倾斜试验的关系  

Relationship between Unexplained Chest Distress and（or） Chest Pain in Children and Head - Up Tilt Test

作　　者：Praveen Kumar 胡春艳 王成 刘晓燕 吴礼嘉 李茗香 曹闽京 林萍 崔晓丽 

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：《实用儿科临床杂志》2009年第1期24-25,共2页Journal of Applied Clinical Pediatrics

基　　金：基金项目：湖南省科技厅项目资助（2008SK3111）;湖南省研究生创新基金项目资助（2340-74335000016）

摘　　要：目的探讨儿童不明原因胸闷和（或）胸痛与直立倾斜试验（HUTT）的关系。方法2002年1月-2008年7月在本院儿科晕厥专科门诊就诊的以不明原因胸闷和（或）胸痛为主要症状的儿童25例为研究组。男19例，女6例；年龄6～13（9．98±2．18）岁。同期在晕厥专科就诊的以不明原因头晕为主要症状的64例儿童为对照组。男38例，女26例；年龄6～13（10．28±2．28）岁。二组儿童均经详细询问病史、体格检查、常规12导联心电图、胸部x线片、超声心动图、脑电图、头颅cT或MRI、血液生化等一系列检查排除器质性心、肺及胸壁、脑等疾病。二组均行HUTT检查，基础直立倾斜试验（BHUT）阴性者，行舌下含服硝酸甘油倾斜试验（SNHUT）。应用SPSS16．0软件进行统计学分析。结果研究组中11例HUTT阳性，其中3例为混合型，8例为血管抑制型；对照组中35例HUTT阳性，其中3例为混合型，32例为血管抑制型。HUTT阳性率研究组为44％，对照组为55％，二组比较差异无统计学意义（P〉0．05）。二组HUTT反应类型构成比差异亦无统计学意义（P〉0．05）。结论儿童不明原因胸闷和（或）胸痛可能与自主神经功能紊乱密切相关。对不明原因胸闷和（或）胸痛而无器质性心血管疾病的儿童，及时行HUTT检查有助于明确病因诊断。Objective To explore the relationship between unexplained chest distress and （or） chest pain in children and head -up tilt test （HuTr）. Methods Between Jan. 2002 and Jul. 2008,25 children with unexplained chest distress and （or） chest pain as their main symptom which including 19 male and 6 female and aged 6 - 13 （9.98 ＋2.18） years,and 64 children with dizziness as their main symptom which including 38 male and 26 female and aged 6 - 14 （ 10.28 ~ 2.28 ） years, were included in the study as research group and control group, respectively. They all came from syncope department of the Second Xiangya Hospital of Central South University and 2 groups of chil- dren had been asked in detail about the history, physical examination, routine 12 - lead electrocardiogram, chest X - ray, echocardiogram, elec- troencephalogram, head computer tomography （CT） or magnetic resonance imaging （ MRI ）, blood and a series of checks to exclude organic heart ,the chest wall and lung,brain diseases. Children of the 2 group underwent HUTT. If the subject had a negative response in baseline head - up tilt test （ BHUT）, he or she would undergo sublingual nitroglycerin head - up tilt test （SNHUT）. Results There were 11 cases in research group had a positive response in HUTT,3 of them were mixed response and 8 of them were vaso - depressor response. There were 35 cases in control group had positive response in HUTT,3 of them were mixed response and 32 of them were vaso - depressor response. The positive rates of HUTT of research group and control group were 44% and 55% ,respectively. The positive rate of HUTY of the 2 groups showed no diffe- rences （ P 〉 0.05 ）. The reaction types of the 2 groups also showed no differences （ P 〉 0.05 ）. Conclusions Unexplained chest distress and （or） chest pain of children may has close relationship with the autonomic disturbance. As for children with unexplained chest distress and （or） chest pain without organic cardiovascular disease, HUTT in a timely

关 键 词：胸闷 胸痛 头晕 直立倾斜试验 儿童 

分 类 号：R725.4[医药卫生—儿科]