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目的研究儿童血管迷走性晕厥(vasovagal syncope,VVS)临床情况。方法 2000年1月至2009年9月在中南大学湘雅二医院儿科门诊就诊或住院的不明原因晕厥或先兆晕厥患儿841例,依据检查年限分为两组,2000年1月至2004年12月为A组,共129例;2005年1月至2009年9月为B组,共712例;并按照年龄分为4岁～、7岁～及11～18岁3个年龄组。经直立倾斜试验(head-uptilttabletest,HUTT)检查诊断为VVS。结果 HUTT总阳性率为45.3%(381/841),B组阳性率较A组明显增加(47.5%vs33.3%,P<0.05)。HUTT阳性率女性高于男性(49.3%vs37.9%,P<0.05)。HUTT阳性率随年龄增长而增加,11～18岁组>7岁～组>4岁～组(49.2%vs44.1%vs37.1%),组间比较差异有统计学意义;7岁～组和11～18岁组中B组HUTT阳性率明显高于A组(46.2%vs27.8%;54.0%vs32.6%,P<0.05)。HUTT阳性率反应类型比较,依次为血管抑制型>混合型>心脏抑制型(70.9%vs25.5%vs3.6%),组间比较差异有统计学意义,其中血管抑制型表现为B组HUTT阳性率高于A组(72.5%vs58.1%,P<0.05)。结论近5年VVS的发生率、反应类型发生显著变化,提示VVS的发生受社会因素、精神因素、生活方式等多种因素的影响。
Objective To study the clinical status of vasovagal syncope (VVS) in children. METHODS: From January 2000 to September 2009, 841 children with unexplained syncope or presyncope were admitted to the pediatric outpatient department of Xiangya Second Hospital of Central South University. They were divided into two groups according to the examination period, January 2000 to 2004 12 Month for the A group, a total of 129 cases; January 2005 to September 2009 for the B group, a total of 712 cases; and according to age is divided into 4 years old, 7 years old and 11 to 18 years old three age groups. VVS was diagnosed by head-up tilt test (HUTT). Results The positive rate of HUTT was 45.3% (381/841). The positive rate of HUTT in group B was significantly higher than that in group A (47.5% vs 33.3%, P <0.05). The positive rate of HUTT was higher in women than in men (49.3% vs37.9%, P <0.05). The positive rate of HUTT increased with age, ranging from 11 to 18 years old> 7 years old to> 4 years old (49.2% vs 44.1% vs 37.1%). There was significant difference between the two groups The positive rate of HUTT in group B was significantly higher than that in group A (46.2% vs27.8%; 54.0% vs32.6%, P <0.05). The positive reaction rate of HUTT was Vascular Inhibition> Mixed> Cardiac Inhibition (70.9% vs25.5% vs3.6%). There were significant differences between the two groups The positive rate was higher in group A than in group A (72.5% vs 58.1%, P <0.05). Conclusion The incidence of VVS and the type of reaction have changed significantly in recent 5 years, suggesting that the occurrence of VVS is influenced by many factors such as social factors, mental factors and life style.