血管迷走性晕厥儿童心电图aVR导联T波振幅变化  

Changes of T wave amplitude in lead aVR of children with vasovagal syncope

作　　者：王兰梅[1] 许毅[1] 王成[1] 吴礼嘉[1] 袁鹤立[1] 曹闽京[1] 林萍[1] 崔晓丽[1] 李芳[1] 祝立平[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》2011年第1期61-64,共4页Chinese Journal of Critical Care Medicine

基　　金：湖南省科技厅资助项目（2008SK3111）;中南大学研究生学位论文创新基金项目（2010ssxt291）

摘　　要：目的 探讨血管迷走性晕厥（VVS）儿童卧位、立位心电图aVR导联T波振幅变化的意义.方法 选择直立倾斜试验（HUTT）阳性的VVS患儿76例为研究组,年龄4～17岁,平均（11.06±2.37）岁.用SR-1000A心电综合自动分析仪描记卧位及立位12导联同步体表心电图,匹配健康儿童55例为对照组.选择波形清晰的窦性心律3个心动周期,测量aVR导联3个心动周期T波振幅取其平均值.结果 ①心电图aVR导联T波振幅（TaVR）在卧位时两组比较差异无统计学意义（P〉0.05）,立位时在研究组明显降低（P＜0.05） 两组均表现为女性较男性降低（P＜0.05）.②aVR导联卧位、立位T波振幅差在研究组大于对照组（P＜0.05） 在对照组女性变化较男性明显（P＜0.05）,在研究组未显示性别差异（P〉0.05） 在晕厥频次之间的差异无统计学意义（P〉0.05）.③研究组中血管抑制型较其他类型（心脏抑制型及混合型）TaVR在卧位、立位时及卧位、立位T波振幅差均无统计学意义（P＜0.05）.结论 卧位、立位体位变化可引起TaVR变化,表明TaVR对心脏自主神经功能评价具有指导价值,但TaVR对VVS复发没有预测价值.Objective To probe the changes of T wave amplitude in lead aVR （TaVR） in supine and erect position of children with vasovagal syncope （VVS）. Methods Twelve - lead simultaneous body surface electrocardiogram in supine and erect position were taken in 76 cases which were positive in head - up tilt test （HUTT） with VVS （ research group） aged from 4 to 17 [ mean （ 11.06 ±2. 37 ） years old ] and 55 healthy children as control group with SR - 1000A automated electrocardiography. The T wave amplitudes were tested by hand during 3 clear wave cycles. Results （1）There was no statistical difference in TaVR between two groups in supine position （ P 〉 0.05 ）. Compared with supine position,the lowering of TaVR of research group was significantly obvious in erect position （P 〈0.05 ）. TaVR of females in both groups was significant lower than boys （ P 〈 0.05 ）.（2）T wave amplitude difference between supine and erect position was more significantly different in the research group than in the control group （ P 〈 0.05 ）, and significantly different in female than in male of control group （P 〈 0.05） ; there were no gender differences in the research group （ P 〉 0.05） and no statistical difference in the frequency of syncope （P 〉 0.05）. （3）There were no statistical differences in TaVR of the erect position, the supine position and in T wave amplitude difference of supine and erect position in vascular suppression type of VVS（ P 〉 0.05 ） , compared with other types （ cardiac suppression and mixed type）. Conclusion The change of the body posture from supine to erect can lead to the changes of TaVR, which manifests that this method has directive value for the evaluation of autonomic nervous system function, but TaVR has no clear predictive value for VVS recurrence .

关 键 词：血管迷走神经性晕厥(VVS) 心电描记术 T波振幅 儿童 

分 类 号：R725.422.1[医药卫生—儿科]