患儿血管迷走性晕厥直立倾斜试验血浆C型钠尿肽变化及其意义

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目的探讨血管迷走性晕厥(vasovagal syncope,VVS)患儿血浆C-型钠尿肽(c-type natriuretic peptide,CNP)含量的变化。方法研究对象包括31例VVS患儿,均为2013年12月至2014年6月在北京大学第一医院儿科以直立不耐受症状入院的患儿,均经过详细病史询问、体格检查及相关实验室检查以及直立倾斜试验(HUTT)确诊为VVS,平均年龄为(11±3)岁;32名健康儿童为对照组,均为经过详细病史及体格检查等确定为健康的儿童,平均年龄为(11±2)岁。心率、血压的监测采用无创连续血压监测仪连续监测。血浆CNP的测定采用夹心免疫发光法。结果 VVS组与对照组的性别比、年龄、身高、体重、平卧位血压及心率差异均无统计学意义(P>0.05);VVS患儿血浆中CNP含量明显高于正常儿童[(35.7±21.5)ng/L vs.(23.2±8.0)ng/L,P<0.01)];VVS患儿的晕厥频率与血浆中的CNP含量呈明显正相关(n=31,r=0.85,P<0.01)。VVS组平卧状态下及HUTT中阳性反应时的血浆CNP含量差异无统计学意义[(36.3±21.0)ng/L vs.(42±57)ng/L,P>0.05]。结论 VVS患儿血浆CNP含量高于对照组,且血浆CNP含量与患儿晕厥频率相关,可能参与了VVS的发病过程。 Objective To investigate the changes of plasma C-type natriuretic peptide (CNP) in children with vasovagal syncope (VVS). Methods Subjects included 31 children with VVS, all of whom were admitted to Peking University First Hospital from December 2013 to June 2014 with symptoms of erectile dysfunction. All patients underwent detailed medical history examination, physical examination and related tests The average age was (11 ± 3) years old in VVS and 32 cases of healthy children, all of whom were healthy children after detailed medical history and physical examination. The average age was ( 11 ± 2) years old. Heart rate, blood pressure monitoring using noninvasive continuous blood pressure monitor continuous monitoring. Plasma CNP was measured by sandwich immuno luminescence. Results There was no significant difference in sex ratio, age, height, weight, supine blood pressure and heart rate between VVS group and control group (P> 0.05). The plasma CNP level in VVS group was significantly higher than that in normal group [(35.7 ± 21.5) ng / L vs. (23.2 ± 8.0) ng / L, P <0.01). The syncope frequency in children with VVS was positively correlated with the level of CNP in plasma (n = 31, r = ). There were no significant differences in plasma CNP levels between the VVS group and the HUTT in the supine group [(36.3 ± 21.0) ng / L vs. (42 ± 57) ng / L, P> 0.05]. Conclusion The plasma levels of CNP in children with VVS are higher than those in the control group. The plasma levels of CNP are correlated with the frequency of syncope and may be involved in the pathogenesis of VVS.
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