直立倾斜试验在儿童不明原因晕厥诊断中的应用  

The application of head-up tilt test in the diagnosis of children with unexplained syncope

作　　者：尚丽丽[1] 彭宇阁[1] 刘佳[1] 李晓红[1] 李艳[1] SHANG Lili;PENG Yuge;LIU Jia;LI Xiaohong;LI Yan(Pediatric Heart Medical Center,the Third Affiliate Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院小儿心脏医学中心

出　　处：《中国实用神经疾病杂志》2019年第18期2026-2031,共6页Chinese Journal of Practical Nervous Diseases

基　　金：2018年河南省科技厅科技攻关计划联合共建项目(编号:2018020221)

摘　　要：目的探讨直立倾斜试验在儿童不明原因晕厥诊断中的应用,为临床提供指导。方法回顾性统计2017-01-2019-05在郑州大学第三附属医院门诊或住院部行直立倾斜试验的184例儿童患者资料,分析不同性别、不同年龄、有无晕厥史患儿试验结果的差异。结果(1)75例患者直立倾斜试验呈阳性,阳性率40.76%;其中体位性心动过速综合征40例(53.33%),血管迷走性晕厥25例(33.33%),直立性低血压5例(6.67%),直立性高血压5例(6.67%);(2)不同性别患儿之间阳性率差异无统计学意义(P>0.05),学龄期儿童阳性率高于学龄前期(P<0.05),有晕厥史儿童阳性率显著高于无晕厥史者(P<0.05)。结论直立倾斜试验对儿童不明原因晕厥有较好的诊断价值,学龄期儿童特别是过往有明确晕厥史者其阳性率显著增高。Objective To explore the diagnosis value of head-up tilt test(HUTT)in children with unexplained syncope,and provide guidance for clinic.Methods 184 cases of children with unexplained syncope or dizzy who came from our hospital from January 2017 to May 2019.All children underwent HUTT,then analysis the constitute ratio of positive cases,and compare the difference of positive rates between different groups.Results The total positive 75 cases,make up 40.76%;among the 75 cases,postural tachycardia syndrome(POTS)40 cases(53.33%),vasovagal syncope(VVS)25 cases(33.33%),orthostatic hypotension(OH)and orthostatic hypertension(OHT)were respectvively 5 cases and accounted for 6.67%respectvively.There was no significant difference in positive rate between different genders(P<0.05),the positive rate of high age group was significantly higher than that of low age group(P<0.05),and the positive rate of the group with syncope history was significantly higher than the group without it.Conclusion HUTT has good diagnostic value for children with unexplained syncope,and the positive rate increased significantly in children with high age,especially with history of syncope.

关 键 词：直立倾斜试验 不明原因晕厥 儿童 诊断 

分 类 号：R748[医药卫生—神经病学与精神病学]