【摘要】 目的探讨不同角度直立倾斜试验(HUTT)对儿童血管迷走性晕厥(VVS)诊断的影响。方法2001-01~2005-12在中南大学湘雅二医院晕厥专科门诊就诊或住院的儿童不明原因晕厥(UPS)患者进行HUTT检查226例次,年龄4~18岁,平均(12.12±3.17)岁,男93例,女133例。倾斜角度在2001-01~2005-05采用70°[n=182,平均(12.19±3.20)岁],在2005-06~2005-12采用60°[n=44,平均(11.82±3.02)岁]。根据临床症状分偶发晕厥(n=66,晕厥发作仅1次)与反复晕厥(n=160,晕厥发作≥1次)。HUTT采用基础直立倾斜试验(BHUT)及舌下含服硝酸甘油倾斜试验(SNHUT)。结果倾斜角度、儿童患者性别及试验方式对UPS儿童血流动力学无影响(P>0.05),UPS儿童诊断阳性率及反应类型分布与倾斜角度、儿童患者性别、试验方式及晕厥频次亦无明显关系(P>0.05)。儿童倾斜70°体位感到欠舒适,倾斜60°体位无明显不适感。结论倾斜70°和60°对受试者血流动力学及阳性率无影响,倾斜60°体位较70°感到舒适。推荐临床上在进行儿童HUTT时选择倾斜60°较合适。更多还原

【Abstract】 Objective To explore diagnostic influence of different angles of head-up tilt table test(HUTT) on children with vasovagal syncope(VVS).Methods There were 226(male 93 and female 133) patients of unexplained syncope(UPS) aged from 4 to 18 years old [mean(12.12±3.17)years] who came from syncope department and hospitalization of the Second Xiangya Hospital of Central South University during Jan 2001 to Dec 2005 and made basic head-up tilt table test(BHUT) with power tilt table.Negative cases of BHUT were given sublingual glyceryl trinitrate 0.2 mg and made sublingual nitroglycerin head-up tilt table test(SNHUT).The tilt test angle was 70°(n=182) during Jan 2001 to May 2005 and 60°(n=44) during June 2005 to Dec 2005.The patients were divided into occasional syncope group(n=66,syncope episode only 1 time) and recurrent syncope group(n=160,syncope episode≥1 time).These data were statisticsed by computer with SPSS 11.0 software.Results The tilt test angle and gender of children and test mode were not relation to the hemodynamics of patients(P>0.05).The positive rate and reaction type had nothing to do with the tilt test angle and gender of children and test mode and frequency of syncope(P>0.05).The children felt more comfortable in tilt angle 60° than in 70°.Conclusions The tilt test angle of 60° and 70°don’t affect the positive rate of HUTT and the hemodynamics in children with VVS.The children feel more comfortable in tilt angle 60° than in 70°.The 60°tilt angle of HUTT in children is recommended in clinic.更多还原