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目的探讨直立倾斜试验(HUTT)对儿童血管迷走性晕厥(VVS)反复发作的预测价值。方法2001-01—2006-08在中南大学湘雅二医院晕厥专科门诊就诊或住院的不明原因晕厥患儿251例,男112例,女139例,年龄418(12.25±3.27)岁。依临床晕厥发生频次分A组(晕厥发作仅1次,n=54)、B组(晕厥发作24次,n=137)与C组(晕厥发作≥5次,n=60)。HUTT在取得知情同意后采用基础直立倾斜试验(BHUT,n=251)及舌下含服硝酸甘油倾斜试验(SNHUT,n=92)。结果(1)HUTT阳性率与晕厥频次关系:BHUT阳性率随晕厥频次增加而递增(χ2=4.285,P>0.05),SNHUT阳性率与晕厥频次不呈线性关系(χ2=1.316,P>0.05),HUTT总阳性率(指BHUT阳性率+SNHUT阳性率)亦随晕厥频次增加而递增(χ2=3.809,P>0.05)。(2)HUTT反应类型与晕厥频次关系:无论是BHUT还是SNHUT,反应类型以血管抑制型为主,BHUT或SNHUT在不同晕厥频次组间比较无明显差异(分别为χ2=3.008,P>0.05;χ2=2.426,P>0.05)。结论HUTT与儿童VVS临床晕厥反复发作频次无明显关系,对儿童VVS临床反复晕厥发作没有预测价值。
Objective To investigate the predictive value of Hypertensive Inclination (HUTT) in recurrent vasovagal syncope (VVS) in children. Methods From January 2001 to June 2006, 251 unexplained syncope patients (112 males and 139 females, 418 (12.25 ± 3.27) years old) with syncope were admitted to the Second Xiangya Hospital of Central South University. According to the frequency of clinical syncope, patients in group A (syncope attack only once, n = 54), group B (syncope attack 24 times, n = 137) and group C (syncope attack more than five times, n = 60). The HUTT was tested for basal upright tilt (BHUT, n = 251) and sublingual nitroglycerin tilt (SNHUT, n = 92) after obtaining informed consent. Results (1) The positive rate of HUTT and the frequency of syncope: the positive rate of BHUT increased with the increase of frequency of syncope (χ2 = 4.285, P> 0.05). The positive rate of SNHUT was not linear with the frequency of syncope (χ2 = 1.316, . The positive rate of HUTT (positive rate of BHUT + positive rate of SNHUT) also increased with the increase of frequency of syncope (χ2 = 3.809, P> 0.05). (2) The relationship between the type of HUTT and the frequency of syncope: The type of reaction was predominantly blood vessel inhibition whether in BHUT or SNHUT, and there was no significant difference between BHUT and SNHUT in different syncope frequency groups (χ2 = 3.008, P> 0.05; χ2 = 2.426, P> 0.05). Conclusions HUTT has no significant relationship with the frequency of recurrent seizures in children with VVS, and has no predictive value in the recurrent seizure of children with VVS.