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目的总结儿童体位性心动过速(POTS)24 h动态血压监测(ABPM)变化特点。方法回顾性分析2009年1月至2013年6月因不明原因晕厥先兆、晕厥症状在中南大学湘雅二医院儿童晕厥门诊就诊或住院,经直立倾斜试验(HUTT)诊断明确并同时行ABPM的70例POTS患儿,年龄4~14岁。对照组为同期来门诊进行体检的健康儿童,年龄4~14岁。根据血压昼夜节律将两组再分成“勺型”血压和“非勺型”血压两种情况,并进行比较。结果(1)POTS组昼夜平均血压均低于对照组(P>0.05)。收缩压昼夜差值亦低于对照组(P<0.05),而舒张压昼夜差值在两组差异无统计学意义(P>0.05)。(2)血压昼夜节律:“非勺型”血压在POTS组高于对照组(72.9%vs.45.0%,P<0.01)。POTS组日间平均收缩压、收缩压昼夜差值、舒张压昼夜差值在“勺型”血压亚组高于“非勺型”血压亚组(P<0.05),而夜间平均收缩压、夜间平均舒张压在“勺型”血压亚组低于“非勺型”血压亚组(P<0.05)。结论 POTS儿童平均血压与健康儿童无明显差异,但POTS儿童血压昼夜节律以“非勺型”血压多见。
Objective To summarize the changes of ambulatory blood pressure monitoring (ABPM) in children with orthostatic tachycardia (POTS) at 24 hours. Methods A retrospective analysis of syncope aura was performed for unknown reasons from January 2009 to June 2013. The symptoms of syncope were observed and hospitalized in Children’s Syncope Clinic of Xiangya Second Hospital of Central South University. Hipotaxy was diagnosed by Hipotaxy Incident (HUTT) Cases of POTS children, aged 4 to 14 years old. Control group for the same period outpatient physical examination of healthy children, aged 4 to 14 years. Based on the circadian rhythm of blood pressure, the two groups were subdivided into two groups: “spoon-shaped” and “non-spoon-shaped” blood pressure, and compared. Results (1) The average daily blood pressure of POTS group was lower than that of control group (P> 0.05). The systolic blood pressure difference between day and night was also lower than that of the control group (P <0.05), while the diurnal difference of diastolic blood pressure had no significant difference between the two groups (P> 0.05). (2) circadian rhythm of blood pressure: “non-spoon type” blood pressure was higher in POTS group than in control group (72.9% vs.45.0%, P <0.01). Daytime mean systolic blood pressure, systolic blood pressure diurnal difference and diastolic blood pressure difference in POTS group were higher than those in non-spoon type blood pressure subgroup (P <0.05), while nighttime mean Systolic blood pressure and nighttime mean diastolic blood pressure were lower in the “spoon-type” blood pressure subgroup than in the “non-spoon type” blood pressure subgroup (P <0.05). Conclusion The average blood pressure of POTS children and healthy children no significant difference, but POTS children circadian rhythm to “non-spoon ” blood pressure more common.