血常规参数与血管迷走性晕厥患儿晕厥复发的相关性研究  

Relationship between blood routine test parameters and syncopal recurrence of vasovagal syncope in children

作　　者：宋婧媛 李红霞[1] 李雪迎[2] 王瑜丽[1] 金红芳[1] 杜军保[1] Song Jingyuan Li Hongxia Li Xueying Wang Yuli Jin Hongfang Du Junbao(Department of Pediatrics, Peking University First Hospital, Beijing 100034, China)

机构地区：[1]北京大学第一医院儿科,100034 [2]北京大学第一医院医学统计室,100034

出　　处：《中华儿科杂志》2017年第1期59-63,共5页Chinese Journal of Pediatrics

基　　金：“十二五”国家科技支撑计划（2012BA103803）

摘　　要：目的探讨静脉血血常规参数与血管迷走性晕厥（ VVS）患儿晕厥复发的相关性。方法病例观察性研究，选取2010年11月至2015年10月在北京大学第一医院儿科诊断为VVS的患儿63例为研究对象，男32例，女31例，平均年龄为（11．2±2．7）岁，均采用基础治疗，即避免诱因、直立训练、自主神经功能锻炼及口服补液盐。于2015年12月至2016年1月通过门诊及电话询问，对患儿病情进行专人记录与分析，病例观察时间为10（4，26）个月。采用单因素Cox回归模型和多因素Cox回归模型分析患儿基线静脉血血常规指标、性别、年龄和体质指数（ BMI）等与VVS患儿预后晕厥复发的关系，并以Kaplan－Meier曲线分析VVS患儿的长期预后。结果63例VVS患儿中，血管抑制型31例，心脏抑制型4例，混合型28例；晕厥复发16例（25％），未复发47例（75％）。单因素Cox回归分析结果表明，基线血小板计数（ PLT）[风险比（ HR）＝1．012，95％可信区间（ CI）：1．003-1．022]对患儿无症状生存影响有统计学意义；多因素Cox回归分析结果表明，基线静脉血血红蛋白（HGB）（HR＝1．055，95％CI：1．007-1．105）、平均红细胞血红蛋白含量（MCH）（HR＝0．612，95％CI：0．423-0．884）和PLT（ HR＝1．015，95％CI：1．006-1．024）是影响患儿晕厥复发的相关因素。生存分析结果显示，VVS患儿1、2、3年无症状生存率分别为83％（52／63）、79％（50／63）和75％（47／63）。结论在VVS患儿基线静脉血血常规参数中，HGB、MCH和PLT可能是影响晕厥复发的重要因素。Objective To explore the relationship between venous blood routine test parameters and syncopal recurrence of children with vasovagal syncope （ VVS） .Method Sixty-three children （ male 32, female 31） diagnosed as VVS in Department of Pediatrics , Peking University First Hospital from November 2010 to October 2015 were included in a case observational study .Their mean age was （11.2 ±2.7） years and basic treatment such as predisposing causes avoiding , standing training , autonomic nervous function exercise and oral rehydration salts were advised to them .The clinical data were obtained by out-patient visit and over telephone from December 2015 to January 2016, with a median follow-up period of 10 （4, 26） months.The effects of baseline venous blood routine test parameters , gender, age, and body mass index （ BMI） on syncopal recurrence were studied via univariate and multivariate Cox regression analysis .Kaplan-Meier curve was used to evaluate the long-term prognosis.Result Among the 63 VVS children in this study, 31 cases were diagnosed as VVS vasodepressor type , 4 cases as VVS cardioinhibitory type and 28 cases as VVS mixed type, 16 cases （25%） had experienced recurrence of syncope while 47 cases （75%） had not.The result of univariate analysis of Cox regression showed that baseline platelet count （ PLT） （ HR=1.012,95%CI：1.003 -1.022） had a marked impact on the survival rate .And the result of multivariate analysis of Cox regression showed that baseline hemoglobin concentration （ HGB） （ HR=1.055,95%CI：1.007-1.105）, mean corpuscular hemoglobin （MCH） （HR=0.612,95%CI：0.423 -0.884） and PLT （HR =1.015,95%CI：1.006 -1.024） had significant effects on survival rate of VVS children .In this study, the one-year, two-year, and three-year survival rate were 83% （52/63）, 79% （50/63） and 75%（47/63）, respectively.Conclusion The baseline venous blood routine test parameters HGB , MCH and＆amp;nbsp;PLT might be the influencing factors of the syncopal re

关 键 词：晕厥 血管迷走神经性 复发 儿童 

分 类 号：R725.4[医药卫生—儿科]