论文部分内容阅读
目的探讨血管迷走性晕厥(VVS)儿童心率变异性(HRV)的年龄和性别差异。方法2003—01～2007—05在中南大学湘雅二医院晕厥专科诊治的不明原因晕厥(UPS)儿童54例(晕厥组),其中<12岁儿童22例,直立倾斜试验(HUTF)全部为阳性反应。匹配48例健康儿童为对照(对照组)。晕厥组和对照组儿童均行24 h动态心电图(Holter)检查,数据经TLC3000A 12通道动态心电图分析系统自动分析结合人工干预生成HRV时域指标和频域指标。结果①晕厥儿童HRV性别比较:与男性儿童相比,女性儿童各项时域指标和频域指标均偏低,其中时域指标总体标准差(SDNN)、均值标准差(sDANN)和频域指标总功率(TP)、低频功率(LF)、极低频功率(VLF)降低显著(P<0.01或P<0.05)。②健康儿童HRV性别比较:女性儿童时域指标SDNN、差值均方根(rMSSD)、差值>50 ms的百分比(pNN50)和频域指标TP、VLF、LF低于男性儿童,其中差异有统计学意义的是频域指标VLF(P<0.01)和LF(P<0.05)。③晕厥儿童HRV年龄比较:与≥12岁儿童相比,<12岁儿童时域指标SDNN、SDANN、pNN50和频域指标TP、LF稍降低(均P>0.05)。④健康儿童HRV年龄比较:与≥12岁儿童相比,<12岁儿童时域指标rMSSD、pNN50和频域指标LF、高频功率(HF)偏高,其中差异有统计学意义的是HF(P<0.05),其余指标稍偏低(均P>0.05)。结论VVS儿童自主神经功能异常,其自主神经变化规律的年龄和性别差异与健康儿童不同。
Objective To investigate the age and sex differences of heart rate variability (HRV) in children with vasovagal syncope (VVS). Methods From January 2003 to May 2007, 54 children with syncope (UPS) of unknown origin (Syncope group) were enrolled in the Second Xiangya Hospital of Central South University. Among them, 22 cases were children <12 years old and all were positive for upright tilt test (HUTF) reaction. 48 healthy children as a control (control group). The syncope group and the control group were subjected to 24-hour Holter examination. The data were analyzed by TLC3000A 12-channel Holter analysis system and analyzed with manual intervention to generate HRV time-domain and frequency-domain indexes. Results ① Gender comparison of HRV in children with syncope: Compared with male children, all the time-domain and frequency-domain indexes of female children were low. Among them, SDNN, SDD and frequency domain index Total power (TP), low frequency power (LF) and very low frequency power (VLF) decreased significantly (P <0.01 or P <0.05). (2) HRV gender comparison of healthy children: The indexes of SDNN, rmsSD, pNN50 and TP, VLF and LF of female children were lower than those of male children Statistical significance was frequency domain indicators VLF (P <0.01) and LF (P <0.05). ③ HRV age of children with syncope: SDNN, SDANN, pNN50 and TP, LF of children <12 years old were slightly lower than those of children aged> 12 years old (both P> 0.05). ④ Comparison of HRV age in healthy children: The rMSSD, pNN50, LF and HF of <12-year-old children were higher than those of 12-year-old children, and the difference was statistically significant P <0.05), the other indicators slightly lower (P> 0.05). Conclusions The autonomic nervous dysfunction of children with VVS is different from that of healthy children in age and gender.