中国实用儿科杂志

中国实用儿科杂志

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舌下含服硝酸甘油倾斜试验诊断儿童血管迷走性晕厥的价值

王成;李雯;李茗香;林萍;谢振武;刘利群;郑慧芬   

  1. 中南大学湘雅二医院儿科心血管病研究室，中南大学儿科学研究所(长沙，410011)
  • 收稿日期:2005-01-15 修回日期:2005-07-08 出版日期:2005-11-25 发布日期:2005-11-25
  • 通讯作者: 王成

Clinical diagnostic value of sublingual glyceryl trinitrate provocation headup tilt table test in children’s vasovagal syncope.

Wang Cheng,Li Wen,Li Mingxiang,et al.   

  1. Department of Cardiovascular Pediatrics,The Second Xiangya Hospital,Central South University,Institute of Pediatrics of Central South University,Changsha 410011,China
  • Received:2005-01-15 Revised:2005-07-08 Online:2005-11-25 Published:2005-11-25
  • Contact: Wang Cheng

摘要： 目的 探讨舌下含服硝酸甘油倾斜试验(SNHUT)对儿童血管迷走性晕厥(VVS)的诊断价值。 方法 2001年3月至2005年5月在中南大学湘雅二医院儿童晕厥专科就诊或住院的不明原因晕厥(UPS)患儿143例，年龄4~18(12.10±3.03)岁，男58例，女85例。电动倾斜床直立倾斜70°行基础直立倾斜试验(BHUT)，并对其阴性者中的64例在同一角度直接给予舌下含服硝酸甘油片0.2mg，再次评价试验结果。用SPSS 11.0软件进行微机统计学处理。 结果 (1)BHUT阳性率29.4%(42/143)，其中女性占73.8%(31/42)；SNHUT 64例，阳性44例，阳性率为68.7%。SNHUT显著地提高了VVS的检出率。(2)出现阳性结果的时间：BHUT为(21.31±13.24)min，SNHUT为(5.41±4.23)min。(3)反应类型：BHUT及SNHUT阳性患儿共86例，血管抑制型83.7%(72/86)，女性占53.5%(46/86)；心脏抑制型7.0%(6/86)，均为女性；混合型9.3%(8/86)，女性占62.5%(5/8)。(4)副反应：舌下含服硝酸甘油64例，未见明显不耐受现象或其他副反应。 结论SNHUT能提高儿童VVS诊断阳性率，副反应小，使用方便，可在儿科临床推广。

关键词: 血管迷走性晕厥, 倾斜台试验, 硝酸甘油, 儿童

Abstract: Abstract Objective To probe clinical diagnostic value of sublingual glyceryl trinitrate provocation headup tilt table test in children's vasovagal syncope.Methods There were 143 (male 58 and female 85) patients of unexplained syncope (UPS) aged from 4 to 18 years old (mean 12.10±3.03 years ) who received basic headup tilt table test (BHUT) in 70 degrees with power tilt table.Negative cases of them were given sublingual glyceryl trinitrate 0.2mg and received sublingual glyceryl trinitrate headup tilt table test (SNHUT).The results were evaluated repeatly.These data were statistically analyzed by computer with SPSS 11.0 software.Results①The positive rate in BHUT was 29.4% (42/143),of which the female was 73.8%(31/42).The positive cases were 44 in 64 of SNHUT.The positive rate in SNHUT was 601%(86/143).②The syncope episodes occurred after standing time (21.31±13.24)min in BHUT and (5.41±423)min in SNHUT.③Reaction type:The positive cases were 86 in BHUT and SNHUT.Vasodepressive type was 837%(72/86).Cardioinhibitory type was 7.0%(6/86).Mixed type was 9.3%(8/86).④Side effect:There were no intolerance cases and other side effects in 64 patients with sublingual glyceryl trinitrate.Conclusion SNHUT can increase diagnostic positive rate of VVS in children.Glyceryl trinitrate use is convenient and its side effects are less.SNHUT can be recommended to be used widely in pediatric clinic.

Key words: Glyceryl trinitrate, Children