自主神经功能检测对体位性心动过速综合征的诊断价值

目的 探讨自主神经功能检测对体位性心动过速综合征(POTS)的诊断价值.方法 对POTS患儿26例和健康儿童20例分别测定其瓦式(Valsalva )比值、深呼吸心率差、30 s最长RR间期/15 s最短RR 间期(30/15)比值、卧立位血压差等自主神经功能及12 导联同步体表心电图(12 ECG)QT间期离散度(QTd)、P波离散度(Pd)水平的变化.采用SPSS 13.0软件进行统计学分析.结果 POTS患儿Valsalva比值、深呼吸心率差与健康对照组比较[Valsalva比值:(1.08±0.06) vs (1.22±0.03); 深呼吸心率差:(9.7±1.7) 次·min-1 vs (18.3±1.6)次·min-1] 均明显降低,差异均有统计学意义(t=5.86、11.34,Pa<0.05).与健康对照组比较,POTS患儿最大QT间期(QTmax)、最小QT间期(QTmin)、QTd延长(Pa<0.01),心率校正后最大QT间期(QTcmax)、心率校正后QT间期离散度(QTcd)增大(Pa<0.01,<0.05),而心率校正后最小QT间期(QTcmin)二组比较无统计学差异;二组最大P波时间(Pmax)、最小P波时间(Pmin)、心率校正后最大P波(Pcmax)、心率核正后最小P波(Pcmin)、Pd及心率校正后P波离散度(Pcd)比较,差异均无统计学意义(Pa>0.05).结论 POTS患儿自主神经明显受损,Valsalva比值、深呼吸心率差、QTd可作为诊断POTS的一种新方法.

Diagnostic Value of Autonomic Nerve Function Tests for Postural Orthastatic Tachycardia Syndrome

Objective To explore the diagnostic value of autonomic nerve function tests for children with postural orthastatic tachycardia syndrome(POTS).Methods Cardiovascular autonomic nerve function tests,including response index of Valsalva maneuver,heart rate change with deep respiration,3015 postural ratio,postural change of blood pressure,the variation of QT interval dispersion(QTd) and P-wave dispersion(Pd) of 12-lead simultaneous body surface electrocardiogram were performed in POTS group including 26 cases of POTS and healthy control group including 20 cases of healthy children.The data were analyzed by SPSS 13.0 software.Results Index of Valsalva maneuver ratio and heart rate change with deep respiration of POTS children were significantly lower than those of healthy subjects [Valsalva maneuver index:(1.08±0.06) vs(1.22±0.03);heart rate change with deep respiration:(9.7±1.7) times per min vs(18.3±1.6) times per min,Pa<0.05].In addition,compared with the healthy control group,maximal QT interval(QTmax),minimal QT interval(QTmin) and QTd prolonged(Pa<0.01),maximal QT corrected for heart rate(QTcmax) and QT interval disperision corrected for heart rate(QTcd) were increased(P<0.01,0.05).There were no significant differences in maximal P wave(Pmax),minimal P wave(Pmin),maximal P wave corrected for heart rate(Pcmax),minimal P wave corrected for heart rate(Pcmin),QTcmin,Pd and P wave dispersion corrected for heart rate(Pcd) between the 2 groups(Pa>0.05).Conclusions POTS children showed a significant impaired autonomic nervous function.Index of Valsalva maneuver,heart rate change with deep respiration and QTd can be used as a new diagnostic method of POTS.