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目的探讨血管抑制型血管迷走性晕厥(VVS-V)儿童心室晚电位(VLP)变化。方法收集2006年7月至2013年1月在中南大学湘雅二医院儿童晕厥专科门诊就诊,经直立倾斜试验(HUTT)明确诊断的VVS-V儿童184例(研究组)。年龄4~14岁,平均(10.54±2.15)岁。男85例,平均(10.85±2.01)岁;女99例,平均(10.27±2.24)岁。同期按性别及年龄匹配中南大学湘雅二医院儿童保健专科门诊进行健康检查的儿童105例为对照组。采用广东中山博爱医用电子仪器厂的SR-1000A心电综合自动分析仪对受检者进行VLP检测,比较研究组和对照组儿童VLP变化。结果研究组较对照组心率(HR)降低[(83.96±12.27)次/min对(87.28±13.75)次/min,t=-2.113,P<0.05]、总QRS时间(TQRS)延长[(84.89±12.05)ms对(81.21±8.23)ms,t=3.070,P<0.05]、高频低幅时限(LAS40)延长[(62.43±19.17)ms对(56.79±1.83)ms,t=2.442,P<0.05]、均方根值(RMS40)增加[(28.73±7.23)μV对(26.89±7.36)μV,t=2.059,P<0.05]。结论 VVS-V儿童较健康儿童HR降低,TQRS、LAS40延长,RMS40增加,提示VVS-V儿童有可能会发生心血管恶性事件。
Objective To investigate the changes of ventricular late potentials (VLPs) in children with vasovagal syncope (VVS-V). Methods A total of 184 VVS-V children (study group) were enrolled in this study from July 2006 to January 2013 in the Outpatient Department of Children’s Syncope at the Second Xiangya Hospital of Central South University, and were diagnosed by Hipotaxy Test (HUTT). Age 4 to 14 years, mean (10.54 ± 2.15) years. There were 85 males (mean, 10.85 ± 2.01) and 99 females (mean, 10.27 ± 2.24) years old. The same period by gender and age matched Xiangya Hospital, Central South University, Department of Child Health specialist outpatient examination of 105 cases of children as a control group. The VLP test was performed on SR-1000A ECG analyzer of Guangdong Zhongshan Boai Medical Electronic Instrument Factory to compare the changes of VLP in study group and control group. Results Compared with the control group, the HR of the study group was significantly lower than that of the control group [(83.96 ± 12.27) / min vs (87.28 ± 13.75) / min, t = -2.113, P <0.05] and prolonged total QRS duration (62.43 ± 19.17) ms vs (56.79 ± 1.83) ms, t = 2.442, P (P <0.05), P <0.05], RMS40 increased (28.73 ± 7.23) μV vs (26.89 ± 7.36) μV, t = 2.059, P <0.05). Conclusions The HR of the children with VVS-V is lower than that of the healthy children, and the prolongation of TQRS and LAS40 and the increase of RMS40, suggesting that VVS-V children may have cardiovascular events.