儿童和成人血管迷走性晕厥的临床特征差异

目的 探讨血管迷走性晕厥(VVS)的临床特征在儿童和成人之间的差异.方法 分析255例经直立倾斜试验(HUTT)诊断为VVS的儿童男50例,女86例,平均年龄(12.3±2.6)岁]和成人男29例,女90例,平均年龄(36.4±14.0)岁]的晕厥诱因和先兆症状等,比较不同年龄段(＜18岁及≥18岁)的VVS患者在性别、HUTT方式及晕厥发作时间等方面的差异.结果 (1)男女比例:儿童组为1∶1.7,成人组为1∶3.1,女性比例成人组高于儿童组(P=0.033).(2)VVS先兆症状:胸闷发生率成人组高于儿童组45.4%(54/119)比27.2%(37/136),P=0.003],头痛10.9%(13/119)比20.6%(28/136),P=0.036]及腹痛发生率成人组低于儿童组7.6%(9/119)比19.1%(26/136),P=0.008].(3)VVS发生诱因:成人组环境闷热22.8%(26/114)比12.5%(17/136),P=0.032]和排尿晕厥发生率9.7%(11/114)比1.5%(2/136),P=0.004]高于儿童组.(4)HUTT反应时间:舌下含化硝酸甘油倾斜试验(SNHUT)阶段混合型的平均反应时间成人组较儿童组延长(5.04±2.27)min比(3.50±1.24)min,P=0.036].结论 成人VVS胸闷发生率、因环境闷热和排尿晕厥发生率高于儿童,头痛及腹痛发生率儿童高于成人,成人混合型平均反应时间较儿童延长.VVS临床特征的年龄差异有助于临床诊治.

Clinical characteristics in adults and children with vasovagal syncope

Objective To analyze the clinical characteristics in adults and children with vasovagal syncope(VVS).Methotis Clinical data including head-up tilt table(HUTT)results were analyzed and compared in 136 children(mean age 12.3±2.7 years,50 boys,86 girls)and 119 adults(mean age 36.4±14.0 years, 29 men, 90 women)with VVS.Results (1)There were more female VVS patients in 3.1,P=0.033)in this cohort.(2)The incidence of chest distress in adults group was significantly higher than that in children group 45.4(54/119)vs.27.2%(37/136),P=0.003 ] while the incidence of headache10.9%(13/119)vs.20.6%(28/136),P=0.036]and abdominal pain in children group was significantly higher than that in adults group7.6%(9/119)vs.19.1%(26/136),P=0.008].(3)Incidences of muggy environment 22.8%(26/114)vs.12.5%(17/136),P=0.032 ]and urination VVS 9.7%(11/114)vs.1.5%(2/136),P=0.004]were significantly higher in aduhs group than those in children group.(4)The mean time of mixed response vasogal episode in adults group was significantly longer than that in children group in sublingual nitroglycerin head-up tilt table test(SNHUT)stage(5.04±2.27min vs.3.50±1.24 min,P=0.036).Conclusions The incidences of chest distress,muggy environment and urination VVS were more often and the mean time of vasogal episode of mixed response in SNHUT stage was longer in adults VVS while the incidence of abdominal pain and headache was higher in children VVS patients compared to adults VVS patients.