儿童血管迷走性晕厥临床特征与直立倾斜试验结果的关系  

Relationships between clinical features of vasovagal syncope in children and the result of head - up tilt test

作　　者：何芝香[1] 胡春艳[1] 王成[1] 吴礼嘉[1] 袁鹤立[1] 康美华[1] 祝立平[1] 林萍[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9期798-802,共5页Chinese Journal of Critical Care Medicine

基　　金：基金项目：湖南省科技厅资助项目（No.2008SK3111）;中南大学研究生学位沦义创新基金项目（No.2009ssxt143）

摘　　要：目的研究儿童血管迷走性晕厥（VVS）临床特征与直立倾斜试验（HUTF）结果的关系，探讨临床特征对儿童HUTT结果的预测价值。方法2009—01—2009—12在中南大学湘雅二医院儿科晕厥专科就诊或住院的4～17岁[平均（10．36±2．67）岁]226例表现为不明原因晕厥、头晕、头痛、心慌或心悸等症状的儿童，详细收集患儿的年龄、性别、晕厥史、晕厥次数、临床表现、晕厥家族史等临床特征，行HUTT检查。结果①临床表现：HUTT阳性组124例，HUTT阴性绡102例。HUTT阳性组常见临床表现依次为头晕或头痛（67．74％）、晕厥（44．35％）、胸闷（25％）及面色苍白（12．90％）。HUTT阴性组常见临床表现依次为头晕或头痛（68．65％）、晕厥（21．56％）、胸闷（16．67％）、面色苍白（10．78％）。②HUTT阳性率：〉12岁组患儿显著高于≤12岁组（79．55％VS49．44％，P〈0．01）；女性组显著高于男性组（61．61％VS48．25％，P〈0．05）；有晕厥史组显著高于无晕厥史组（71．05％VS46．67％，P〈0．05）；晕厥1～2次组、晕厥3～4次组及晕厥5～10次组三组比较差异无统计学意义（P〉0．05）；有晕厥家族史组显著高于无娃著晕厥家族史组（71．43％VS49．41％，P〈0．01）。③HUTT反应类型：124例HUTT阳性患儿中，27例为皋础直立倾斜试验（BHUT，血管抑制型20例，混合型7例），97例为舌下含化硝酸甘油倾斜试验（SHNUT，血管抑制型86例，混合型11例）。④Logistic回归分析显示，对HUTF结果有显著影响的临床特征依次为年龄、晕厥家族史及晕厥史。结论VVS患儿年龄、晕厥家族史及晕厥史等临床特征对预测HUTT结果有显著影响。Objective To study the relationships between clinical features of vasovagal syncope （VVS） in children and the result of head - up tilt test （HUTT） in order to investigate the predictive value of clinical features in the resuh of HUTT in children. Methods 226 children aged from 4 to 17 years old eame fl＇om specialist syncope out - patient department or in - patient department of the Second Xiangya Hospital, Central South Universi｜y in January 2009 ~ December 2009 with unexplained syncope, dizziness,headache or palpitation. Their clinical features （ including age,sex,history of syncope,clinical manifestations and family history of syncope） might afieet the results of the HU3T were collected, then the children underwent HUTT. Results （1）Clinical manifestatiuns：HUTT-positive group included 124children, HUTT- negative group included 102 children. HUTT- positive group＇s common clinical manifestations were dizziness or headache （ 67.74% ）, syncope （ 44.35% ）, chest tightness （ 25% ） and pale（ 12.90% ）. HUTT- negative group＇s common clinical manifestations were dizziness or headache （68.65%）, syncope （21.56%）, chest tightness （ 16.67% ） and pale （ 10.78% ）. （2）HUTT positive rate： more than 12 years old group was significantly higher than less than 12 year old group （79.55 % vs 49.44% ,P 〈0.01 ） ; and female group was significantly higher than male group（61.61% vs 48.25%, P 〈 0.05 ） ; children who had history of syncope were significantly higher than those who did not have history of syncope （71.05% vs 46.67% ,P 〈0.05）;there were no significant differences among 1 -2 times history and 3 - 4 times history and 5 ~ 10 times history of syncope group （ P 〉 0.05 ） ; children who had a family history of syncope were significantly higher than those of children who did not have a family history of syncope （ 71.43% vs 49.41% , P 〈 0.01 ）. （3） HUTT response type ： among 124 HUTT - positive children, 27 were baseline head - up tilt tes

关 键 词：晕厥 血管迷走神经性 儿童 直立倾斜试验 临床特征 

分 类 号：R544.2[医药卫生—心血管疾病]