儿童不明原因叹气与直立倾斜试验的关系  

Relationship between unexplained sighs in children and head-up tilt test

作　　者：何笑兰[1,2] 王成[1] 吴礼嘉[1] 林萍[1] 李芳[1] 许毅[1] 

机构地区：[1]中南大学湘雅二医院儿童医学中心儿童心血管专科,中南大学儿科学研究所,长沙410011 [2]株洲市妇幼保健院儿科

出　　处：《中华实用儿科临床杂志》2013年第1期27-28,共2页Chinese Journal of Applied Clinical Pediatrics

基　　金：“十二五”国家科技支撑计划（2012BAI03B03）;湖南省科技厅资助项目（2012FJ3127）

摘　　要：目的探讨儿童不明原因叹气与直立倾斜试验（HUTT）的关系。方法选择在中南大学湘雅二医院儿童医学中心儿童晕厥专科门诊就诊，以不明原因叹气为主要症状的儿童96例。男50例，女46例；年龄4—14岁[（8．55±2．71）岁]。所有儿童均经详细询问病史、体格检查、常规12导联ECG、胸部X线片、超声心动图、心肌酶谱等检查排除器质性胸壁、心、肺等疾病后，行HUTT检查。结果HUTT阳性率为31．25％（30／96例），男女HUTT阳性率比较差异无统计学意义[20．00％（10／50例）比43．48％（20／46例）,χ^2=3．196，P〉0．05]。其中基础直立倾斜试验（BHUT）阳性2例（6．67％），舌下含化硝酸甘油倾斜试验（SNHUT）阳性28例（93．33％）；血流动力学改变为血管抑制型26例（86．67％），心脏抑制型1例（3．33％），混合型3例（10．00％）。结论近1／3的儿童不明原因叹气与自主神经功能紊乱相关。临床上对不明原因叹气的儿童行HUTT检查有助于明确病因。Objective To explore the relationship between unexplained sighs in children and head-up tilt test （HUTF）. Methods Ninety-six eases of children with the main symptom of unexplained sighs were received at Specialist Out-Patient Clinic of Children＇s Syncope from May 2003 to Mar. 2012 in the Second Xiangya Hospital of Central South University, aged 4 - 14 years old（50 cases were male ,46 cases were female）, with a mean age of （8. 55 ±2.71 ） years. The detailed history, physical examinations, conventional 12 lead electrocardiogram, chest x-ray, and echocardiography were all investigated, as well as the examination of myocardial enzyme, to eliminate the disorders of organic chest wall, heart,lung disease, and then HUTF inspection was given to them. Results HUTT positive rate was 31.25 % （30/ 96 cases） ,and no gender differences were found[20.00% （ 10/50 cases） vs 43.48% （20/46 cases） ,χ^2 =3. 196 ,P 〉 0.05 ]. The positive cases included the basic head-up tilt table test in 2 cases （ 6.67% ） and suhlingua] nitroglycerin head-up tilt test in 28 patients（93.33% ）. The hemodynamic changes in HUTT were found in 26 cases of vascular inhibited type（86.67% ） ,heart inhibited type in 1 patient（3.33% ） and the mixed type in 3 cases（ 10.00% ）. Conclusions Almost a third of children with unexplained sighs are related to the autonomic function disorder. HUTT may help to determine the causes of clinical unexplained sighs in children.

关 键 词：叹气 直立倾斜试验 儿童 

分 类 号：R72[医药卫生—儿科]