目的:探讨儿童体位性心动过速综合征(POTS)合并血管迷走性晕厥(VVS)的诊断。方法:回顾性地复习2007年1月至2010年12月经直立倾斜试验(HUT)诊断为POTS的57例儿童的临床资料,其中男29例,女28例,年龄5~16(12.2±1.9)岁。结果:57例POTS儿童中,在可以耐受倾斜体位的前提下,通过延长HUT时间,24例(42%)经HUT诊断合并VVS,其中血管抑制型20例,混合型3例,心脏抑制型1例。合并VVS儿童平均年龄(13.0±1.4岁)大于未合并VVS的POTS儿童(11.5±2.1岁),差异有统计学意义(P0.05)。结论:部分POTS儿童合并VVS,在可以耐受倾斜体位的前提下,延长HUT时间有利于防止VVS漏诊。与未合并VVS的POTS儿童比较,合并VVS儿童年龄较大,但性别、临床症状无明显差异。
Abstract
OBJECTIVE: To study the diagnosis of vasovagal syncope (VVS) in children with postural orthostatic tachycardia syndrome (POTS). METHODS: The clinical data of 57 children with POTS diagnosed by the head-up tilt test between January 2007 and December 2010 were studied retrospectively. Of the 57 children, there were 29 boys and 28 girls who were aged from 5 to 16 years (12.2±1.9 years). RESULTS: Twenty-four (42%) out of 57 children were diagnosed with VVS by prolonging the duration of the head-up tilt test (for the children with orthostatic tolerance): cardioinhibitory (20 cases), mixed (3 cases) and vasoinhibitory (1 case). The POTS children with VVS were older than those without (13.0±1.4 years vs 11.5±2.1 years; P<0.05). There were no significant differences in gender and clinical symptoms between the POTS children with and without VVS. CONCLUSIONS: Some children with POTS may have coexisting VVS, suggesting that it is important to avoid misdiagnosis of VVS by prolonging the duration of head-up tilt test in POTS children with orthostatic tolerance. There are no obvious differences in gender and clinical symptoms between the POTS children with and without VVS.
关键词
体位性心动过速综合征 /
血管迷走性晕厥 /
直立倾斜试验 /
儿童
Key words
Postural orthostatic tachycardia syndrome /
Vasovagal syncope /
Head-up tilt test /
Child
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