改良Calgary评分在儿童心源性晕厥和血管迷走性晕厥鉴别诊断中的意义

目的 分析改良Calgary晕厥症状评分在儿童心源性晕厥和血管迷走性晕厥鉴别诊断中的意义.方法 2002年8月至2011年4月在北京大学第一医院儿科晕厥专业门诊就诊或住院、确诊为心源性晕厥和血管迷走性晕厥的患儿共189例,其中男112例,女77例;年龄2 ～18岁,平均(12.4±3.1)岁.采用改良Cakary晕厥症状评分及其受试者操作特征(receiver operatingcharacteristic,ROC)曲线分析不同Calgray评分对鉴别儿童心源性晕厥和血管迷走性晕厥的预测价值.结果 心源性晕厥患儿的改良Calgary症状评分为-5.00(-7,1),与血管迷走性晕厥患儿改良Calgary症状评分为1(-4,6)]相比,差异有统计学意义(P＜0.01).以改良Calgary晕厥症状评分≤-2.5为界值对心源性晕厥与血管迷走性晕厥患儿进行鉴别的灵敏度和特异度分别为95.4％和67.7％,由于Calgary晕厥症状评分为整数,所以当改良Calgary晕厥症状评分≤-3时,可能为心源性晕厥.结论 改良Calgary晕厥症状评分可能作为临床上鉴别心源性晕厥和血管迷走性晕厥的初步方法.

A modified Calgary syncope syndrome score in the differential diagnosis between cardiac syncope and vasovagal syncope

Objective This study aimed at analyzing the usefulness of a modified Calgary Syncope Syndrome Score in the differential diagnosis between cardiac syncope (CS) and vasovagal syncope (VVS) in children through a large sample clinical study.Method Totally 189 children 112 males,77 females,aged 2 - 18 yrs,mean age ( 12.4 ±3.1 ) yrs] with CS and VVS who were at the syncope clinic or admitted to the Department of Pediatrics,Peking University First Hospital from August 2002 to April 2011 were included in the study.The diagnosis was analyzed by a modified Calgary Syncope Syndrome Score and receiver operating characteristic (ROC) curve was used to explore the predictive value of different Calgary Syncope Syndrome Scores in differential diagnosis between CS and VVS.Result There were significant differences in the score between CS -5.00 ( -7,1)] and VVS 1 ( -4,6) ] (P ＜0.01).When the score was ≤ - 2.5,the sensitivity and specificity of the differential diagnosis between CS and VVS were 95.4％ and 67.7％,respectively.Since the modified Calgary Syncope Syndrome Score was integer number,CS should be considered when the score was less than -3. Conclusion The modified Calgary Syncope Syndrome Score might be used as an initial diagnostic method in differential diagnosis between CS and VVS,based on the history of the patients.