儿童体位性心动过速综合征24h动态血压变化研究  

Changes of 24h ambulatory blood pressure in children with postural orthostatic tachycardia syndrome

作　　者：冉静[1,2] 王成[1,2] 林萍[1,2] 邹润梅[1,2] 吴礼嘉[1,2] 李芳[1,2] 

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 [2]中南大学儿科学研究所,湖南长沙410011

出　　处：《中国实用儿科杂志》2015年第8期618-621,共4页Chinese Journal of Practical Pediatrics

基　　金：湖南省卫生厅课题(B2013-013)

摘　　要：目的总结儿重体位性心动过速（POTS）24h动态血压监测（ABPM）变化特点。方法回顾性分析2009年1月至2013年6月因不明原因晕厥先兆、晕厥症状在中南大学湘雅二医院儿童晕厥门诊就诊或住院，经直立倾斜试验（HUTT）诊断明确并同时行ABPM的70例POTS患儿，年龄4～14岁。对照组为同期来门诊进行体检的健康儿童，年龄4—14岁。根据血压昼夜节律将两组再分成“勺型”血压和“非勺型”血压两种情况，并进行比较。结果（1）POTS组昼夜平均血压均低于对照组（P〉0．05）。收缩压昼夜差值亦低于对照组（P〈0．05），而舒张压昼夜差值在两组差异无统计学意义（P〉0．05）。（2）血压昼夜节律：“非勺型”血压在POTS组高于对照组（72．9％郴．45．0％，P〈0．01）。POTS组日间平均收缩压、收缩压昼夜差值、舒张压昼夜差值在“勺型”血压亚组高于“非勺型”血压亚组（P〈0．05），而夜间平均收缩压、夜间平均舒张压在“勺型”血压亚组低于“非勺型”血压亚组（P〈0．05）。结论POTS儿童平均血压与健康儿童无明显差异，但POTS儿童血压昼夜节律以“非勺型”血压多见。Objective To explore the changes of 24h ambulatory blood pressure in children with postural orthostatic tachycardia syndrome （POTS）. Methods The study included 70 children （31 males and 39 females with mean age of 11.14± 2.22 years ） visiting or hospitalized in the Second Xiangya Hospital of Central South University due to unexplained presyncope, symptoms of syncope and finally diagnosed as POTS after head up tilt test （HUTT） ;each patient completed 24h ambulatory blood pressure monitoring （ABPM）simultaneously. Forty healthy children （22 males and 18 females with mean age of 10.60±2.38 years） were as controls. According to the circadian rhythm of blood pressure, both POTS group and controls were divided into dipper blood pressure and non-dipper blood pressure subgroups. HuTr and ABPM were performed in both groups during the same time. Statistical analysis was accomplished by SPSS 17.0 statistical software. Results （ 1 ）The 24h mean pressure ： 24h mean systolic blood pressure（24h SBP）, 24h mean diastolic blood pressure（24h DBP）, daytime mean systolic blood pressure （DSBP）, daytime mean diastolic blood pressure （DDBP）, nocturnal mean systolic blood pressure （NSBP）, and nocturnal mean diastolic blood pressure （NDBP） were all lower in POTS group than those in control group （P 〉 0.05）. The systolic pressure differences in the daytime and at night were lower than those of control group （P 〈 0.05 ）. The diastolic blood pressure differences in the daytime and at night were similar in both groups （P 〉 0.05）. （2） Blood pressure pattern ： the proportion of non-dipper blood pressure was significantly higher in the POTS group than in the control group （72.9% vs. 45.0% ,P 〈 0.01 ） ; daytime mean systolic blood pressure, the systolic pressure differences in the daytime and at night and the diastolic pressure differences in the daytime and at night were higher in dipper blood pressure than those of non-dipper blood pressure pattern with POTS （P �

关 键 词：体位性心动过速综合征 24H动态血压监测 儿童 

分 类 号：R72[医药卫生—儿科]