儿童血管迷走性晕厥与焦虑的关系研究  

The relationship between vasovagal syncope and anxiety in children

作　　者：丁异熠[1,2] 王成[1] 刘晓燕[3] 林萍[1] 吴礼嘉[1] 薛小红[4] 李茗香[1] Praveen Kumar 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 [2]湖南省常德市第一人民医院儿科,湖南常德415003 [3]湖南省长沙市中心医院儿科,长沙410004 [4]湖南省妇幼保健院儿科,长沙410008

出　　处：《中国实用儿科杂志》2009年第7期536-538,共3页Chinese Journal of Practical Pediatrics

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

摘　　要：目的探讨儿童血管迷走性晕厥(VVS)与焦虑的关系。方法2007年6月至2007年11月在中南大学湘雅二医院儿童晕厥专科门诊就诊或住院的VVS患儿84例,其中男47例,女37例;年龄7～16岁,平均(11.01±2.00)岁。将VVS患儿分为直立倾斜试验(HUTT)阴性组(41例)和HUTT阳性组(43例),再将HUTT阳性组依临床症状分为头晕组与晕厥组。所有受试儿童完成儿童焦虑性情绪障碍筛查表(SCARED),用统计软件SPSS11.0进行数据分析。结果(1)HUTT阴性组与HUTT阳性组SCARED得分比较:躯体化或惊恐、广泛性焦虑与焦虑量表总分HUTT阴性组高于HUTT阳性组,分离性焦虑、社交恐怖与学校恐怖得分HUTT阴性组低于HUTT阳性组,但差异均无统计学意义(P>0.05)。(2)HUTT阳性组、阴性组与全国城市常模组(常模组)SCARED得分比较:躯体化或惊恐、广泛性焦虑、分离性焦虑、社交恐怖、学校恐怖与焦虑量表总分均明显高于常模组(P<0.05)。(3)HUTT阳性头晕组与晕厥组SCARED得分比较:躯体化或惊恐、广泛性焦虑、分离性焦虑、社交恐怖及焦虑量表总分头晕组高于晕厥组,但差异无统计学意义(P>0.05);学校恐怖得分头晕组明显高于晕厥组(P<0.05)。结论儿童VVS中焦虑发生率高。儿童VVS躯体化或惊恐、广泛性焦虑、分离性焦虑、社交恐怖与学校恐怖普遍存在,但这些焦虑症状与HUTT结果关联不明显。HUTT阳性患儿中,没有晕厥病史的VVS患儿焦虑评分更高。提示心理因素如焦虑在儿童VVS发生、发展、治疗及预后中可能起重要作用。Objective To investigate depression in the children with VVS, and explore the relationship between VVS and depression in children. Methods A total of 84 out-patients and hospital patients at the Second Xiangya Hospital, Central South University from Jun, 2007 to November , 2007 with unexplained syncope or prodromata （47 boys, 37 girls, age 7-16 yrs, mean 11.01 ±2.00 yrs） were enrolled in this study. According to the result of head-up tilt table test （HUTT） , they were divided into HUTT-negative group （n = 41 ） and HUTT-positive group （n = 43 ）, and in the H UTT positive group, according to the symptoms they were further divided into dizziness group and syncope group. All the subjects were asked to complete the Screen for Child Anxiety Related Emotional Disorders （SCARED）. SPSS 11.0 of tware was used for the statistical analysis of these data. Results （ 1）Comparison of SCARED scores between HUTT-positive group and HUTT-negative group： HUTT-negative group got a higher mark than HUTT-positive group in panic/somatic, general anxiety and total score of SCARED （P 〉 0.05）, but got a lower mark in separation anxiety, social phobia and school phobia （P 〉 0.05 ）. （2） Comparison of SCARED scores between HUTT-positive group, HUTT negative group and normal group ： both HUTT-positive and negative group got a higher mark than normal group in panic/somatic, general anxiety, separation anxiety, social phobia , school phobia and total score of SCARED （P 〈 0.05）. （3）Comparison of dizziness group and syncope group in HUTT-positive group： dizziness group got a higher mark than syncope group of HUTT-positive group in school phobia （P 〈 0.05）, panic/somatic, general anxiety, separation anxiety, social phobia and total score of SCARED （P 〉 0.05）. Conclusion Anxiety is common among VVS children. Panic/somatic, general anxiety, separation anxiety, social phobia and school phobia are common in VVS of children, but have no obvious connection with the result of HUTI＇. VV

关 键 词：血管迷走性晕厥 直立倾斜试验 心理因素 焦虑 儿童 

分 类 号：R72[医药卫生—儿科]