直立倾斜试验对儿童血管迷走性晕厥的诊断价值  

Diagnostic value of head-up tilt test for vasovagal syncope in children

作　　者：张菊花 王一工 宋雨 Zhang Juhua;Wang Yigong;Song Yu(Functional Examination Section,Zhumadian Central Hospital,Zhumadian 463000,China)

机构地区：[1]河南省驻马店市中心医院功能检查科,463000

出　　处：《中国实用医刊》2021年第5期39-42,共4页Chinese Journal of Practical Medicine

摘　　要：目的探究直立倾斜试验(HUTT)对儿童血管迷走神经晕厥(VVS)的诊断价值。方法抽取2019年1月至2020年1月于驻马店市中心医院就诊的不明原因晕厥患儿186例,根据其临床晕厥发作频率分为偶发组68例(晕厥发作1~2次)和反复组118例(晕厥发作≥3次),所有患儿均行HUTT,观察比较两组患儿试验过程中血压、心率的变化及HUTT阳性率,并进行分析。结果试验后,两组收缩压、舒张压、心率均较试验前降低(P<0.05),且反复组试验后收缩压、舒张压、心率水平低于偶发组(P<0.05)。186例患儿中127例出现HUTT阳性反应,诱发发作时间为(21.37±5.43)min,其中反复组HUTT阳性率(77.12%,91/118)高于偶发组(52.94%,36/68),P<0.05。反复组血管抑制型和心脏抑制型阳性反应比例均高于偶发组[59.32%(70/118)比44.12%(30/68),13.56%(16/118)比4.41%(3/68)],P<0.05。与试验前比较,血管抑制型患儿试验后收缩压、舒张压降低,心率变快;心脏抑制型患儿试验后心率减慢而收缩压、舒张压无明显变化;混合型患儿试验后收缩压、舒张压、心率均下降(P均<0.05)。试验期间两组均未出现严重不良反应。结论HUTT可作为儿童VVS的一种有效诊断方法,通过观察患儿在HUTT中的血压及心率变化可明确其HUTT阳性反应类型。Objective To investigate the diagnostic value of head-up tilt test(HUTT)for vasovagal syncope(VVS)in children.Methods A total of 186 children with unexplained syncope who were admitted to Zhumadian Central Hospital from January 2019 to January 2020 were selected.According to their frequency of clinical syncope,they were divided into incident group(68 cases,1 to 2 syncope episodes)and recurrent group(118 cases,syncope episodes≥3 times).HUTT was performed on all the children.The blood pressure,heart rate(HR)changes,and the positive rate of HUTT were observed and compared between the two groups.Results After the test,the systolic blood pressure(SBP),diastolic blood pressure(DBP),and HR of the two groups were lower than those before the test(P<0.05),and the levels of SBP,DBP and HR in recurrent group were lower than those in the incident group(P<0.05).Among 186 children,127 children were with a positive HUTT reaction,and the onset time was(21.37±5.43)min.The positive rate of HUTT in recurrent group(77.12%,91/118)was higher than that in incident group(52.94%,36/68),P<0.05.The proportions of positive reactions of the vascular inhibitory and cardiac inhibitory types in recurrent group were 59.32%(70/118)and 13.56%(16/118),higher than 44.12%(30/68)and 4.41%(3/68)in the incident group(P<0.05).Compared with indexes before the test,SBP and DBP decreased and HR became faster in children with angiogenesis after the test.The HR slowed down after the test in children with cardiosuppression,but there was no significant change in SBP and DBP.The SBP,DBP and HR significantly decreased in children with mixed type after the test(P<0.05).During the test,there were no serious adverse reactions in neither group.Conclusions HUTT can be used as an effective diagnostic method for pediatric VVS.Observing the changes of blood pressure and HR in HUTT patients can clarify the type of HUTT positive reaction.

关 键 词：儿童 血管迷走神经晕厥 直立倾斜试验 诊断价值 

分 类 号：R725.4[医药卫生—儿科]