斜板试验诊断小儿血管迷走性晕厥的价值及饮水试验的防治效果

目的探讨小儿血管迷走性晕厥(VVS)的诊断及防治方法。 方法分析1999-10—2004-07上海交通大学附属儿童医院开展斜板试验(TT)(倾斜角度80°，试验时间持续30min)的状况，对不明原因晕厥组74例 及正常对照组54例进行前瞻性研究，对TT阳性组加做阳转阴试验，予以饮水试验，并随访。 结果基础TT在不明原因晕厥组中阳性41例，阳性率为55.4%,对照组为0(P<0.001)。阳性组表现血管抑制型21例,心脏抑制型7例，混合型13例； 28/41(68.3%)例患儿经饮水后阳转阴；随访38例TT阳性患儿，总有效率86.8%。 结论TT对诊断小儿血管迷走性晕厥有较高的敏感性(55.4%)和特异性(100%)。阳转阴试验为防治小儿血管迷走性晕厥提供了理论和实验依据，饮 水试验是一种简单有效可行的防治措施。

The value of TT for diagnosing vasovagal syncope in children and the clinical efficacy of drinking-water.

AbstractObjectiveTo study the value of Tilt-table test (TT) for diagnosing vasovagal syncope and the clinical efficacy of drinking- water. MethodsIn prospective study,74 patients with unexplained syncope and 54 healthy children received the TT to 80° for 30 minutes.Positive-to-negative test was performed in the positive group,who eventually were treated with drinking-water,and were followed up. ResultsThe classic TT was positive in 55.4% of patients with unexplained syncope,but none in control subjects.Three patterns of positive response to TT were observed :vasodepressor pattern in 21/41,cardioinhibitory pattern in7/41,and mixed pattern in 13/41.Among the positive group,28/41turned negative after drinking water.Follow-up was available to 38 patients,the total effective rate being 86.8%. ConclusionTT has higher sensibility and specificity to the diagnosis of vasovagal syncope.Positive-to-negative test provides rational and experimental evidence.Drinking-water is a simple and effective measure for the prevention of vasovagal syncope.