【摘要】 目的　探讨不明原因晕厥患儿在直立倾斜试验中血流动力学反应模式及构成比例。方法　对 2 0 0 1年1月至 2 0 0 3年 12月北京大学第一医院儿科收治的 90例不明原因晕厥患儿在安静环境下进行直立倾斜试验或硝酸甘油激发的直立倾斜试验 ,持续监测患儿心率和血压变化。结果　 90例不明原因晕厥患儿直立倾斜试验中 ,经典的血管迷走性反应者 4 9例 ( 5 4 4 % ) ,其中血管抑制型 33例 ( 36 7% ) ,心脏抑制型 6例 ( 6 7% ) ,混合型 10例( 11 1% )。正常直立反应者 12例 ( 13 3% ) ,体位性心动过速反应者 2 8例 ( 31 1% ) ,直立性低血压反应者 1例( 1 1% ) ,没有发现自主神经反应障碍型及心脏变时功能障碍型。结论　不明原因晕厥患儿在直立倾斜试验中以经典的血管迷走性反应为主 ,其次为体位性心动过速综合征的反应 ,还可能出现体位性低血压等其他的异常血流动力学变化更多还原

【Abstract】 Objective To investigate different hemodynamic patterns during the course of head up tilt tests in children with unexplained syncope.Methods Ninety patients with unexplained syncope underwent head up tilt tests or head up tilt tests potentiated with nitroglycerine in quiet circumstance.Blood pressure and heart rate were monitored simultaneously.Results Forty nine(54 4%) of 90 children with unexplained syncope displayed the hemodynamic pattern of vasovagal response,among whom 33(36 7%)displayed the pattern of vasodepressor response,6(6 7%)cardioinhibitory response and 10(11 1%)mixed response.Of the other 41 negative patients,among whom 28(31 1%)displayed postural orthostatic tachycardia syndrome(POTS),1(1 1%)orthostatic hypotension(OH),12(13 3%) normal hemodynamic response,and patterns of dysautonomic response and chronotropic incompetence were not observed in children with unexplained syncope.Conclusion Classical vasovagal response is the major hemodynamic pattern in the course of HUTT in children with unexplained syncope,and the secondary abnormal hemodynamic response is POTS.But there are still other abnormal hemodynamic patterns including OH.更多还原