儿童血管迷走性晕厥和体位性心动过速综合征共患过敏性疾病的临床特征分析

发布时间：2018-05-12 18:00

本文选题：晕厥 + 血管迷走性　；参考：《北京大学学报(医学版)》2017年05期

【摘要】：目的:探讨儿童血管迷走性晕厥(vasovagal syncope,VVS)及体位性心动过速综合征(postural tachycardia syndrome,POTS)共患过敏性疾病的临床特点。方法:回顾性分析67例VVS及POTS儿童的临床资料,比较共患过敏性疾病与非共患过敏性疾病患儿的一般情况、症状评估、过敏指标以及直立试验或直立倾斜试验中的血流动力学特点,组间比较采用独立样本t检验或秩和检验,组成比比较采用χ2检验。采用双变量相关分析检验嗜酸性粒细胞百分比及计数与症状评分/晕厥发生频率的相关性。P0.05为差异有统计学意义。结果:67例患儿中(VVS43例,POTS 24例)共有21例(31%)共患过敏性疾病,伴随的过敏性疾病包括过敏性鼻炎、支气管哮喘、变应性皮炎及食物过敏,其中以过敏性鼻炎最为常见。过敏组与非过敏组患儿在就诊年龄、性别比例、基础血压方面差异无统计学意义。与非过敏组相比,过敏组的起病年龄(月)较大[11±2 vs.9±3],病程(月)偏短[8.0(0.1,24.0)vs.12.0(0.1,144.0)]。在VVS患儿中过敏组晕厥发生频率(次/月)较非过敏组高[2.50(0.08,30.00)vs.0.25(0.03,5.00)]。过敏组嗜酸性粒细胞百分比(%)[3.50(0.70,5.90)vs.1.65(0.30,6.20)]及计数(×109)[0.18(0.05,0.71)vs.0.10(0.02,0.38)]较非过敏组更高,P均0.05。VVS患儿中,过敏组与非过敏组相比直立倾斜试验阳性反应时间差异无统计学意义。在POTS患儿中,过敏组与非过敏组患儿在直立不耐受症状评分及直立试验中心率增加最大值方面差异无统计学意义。结论:过敏性疾病是VVS及POTS儿童常见的共患病,其中过敏性鼻炎最为常见;具有过敏性疾病的患儿出现直立不耐受表现的起病年龄较大,更可能因短期内发作较为频繁而就诊;VVS合并过敏性疾病时晕厥发生频率更高。
[Abstract]:Objective: to investigate the clinical features of vasovagal syncope (VVSs) and postural tachycardia syndromes (POTS) in children with vasovagal syncope. Methods: the clinical data of 67 children with VVS and POTS were analyzed retrospectively. The anaphylaxis index and hemodynamic characteristics in vertical or vertical tilt test were compared by independent sample t test or rank sum test, and 蠂 2 test was used for composition ratio comparison. Bivariate correlation analysis was used to test the correlation between the percentage of eosinophils and the number of eosinophils and the symptom score / frequency of syncope. Results there were 21 cases of allergic diseases (including allergic rhinitis, bronchial asthma, allergic dermatitis, allergic dermatitis and food allergy), among which allergic rhinitis was the most common. There was no significant difference in age, sex ratio and basic blood pressure between allergic group and non-allergic group. Compared with the non-allergic group, the onset age (month) of the allergy group was larger [11 卤2 vs.9 卤3], and the course of disease (month) was shorter than that of the non-allergic group [8.0U 0.1vs.12.0 0.1144.0]. The frequency of syncope in allergic group was higher than that in non-allergic group (2.50 ~ 0.08) (2.50 ~ 0.08) and the frequency of syncope in allergy group was higher than that in non-allergy group [2.50 ~ 0.08 ~ 30.00vs.0.25 ~ 0.03V _ (5.00)]. The percentage of eosinophilic granulocytes in allergy group (3.50 ~ 0.70 ~ 5.90) and count (脳 10 ~ (9) [0.18 ~ (0. 05) 0. 71 ~ 0. 01 ~ 0. 02 ~ 0. 38)] in allergy group were higher than those in non allergic group. There was no significant difference in positive reaction time between allergy group and non allergic group in upright tilt test compared with non allergic group. There was no significant difference between allergy group and non-allergic group in the score of erect intolerance symptom and the maximum increase of heart rate in orthostatic test in children with POTS. Conclusion: allergic diseases are common in children with VVS and POTS, among which allergic rhinitis are the most common. The frequency of syncope in patients with VVS complicated with allergic diseases is higher because of frequent short-term attacks.
【作者单位】：北京大学第一医院儿科;
【基金】：北京市科技计划课题(Z171100001017253)资助~~
【分类号】：R725.4

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