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目的探讨儿童体位性心动过速综合征的临床特征(POTS)。方法以符合POTS诊断标准的60例患儿为研究对象,分析年龄分布、家族遗传特征及血液动力学指标,同时观察其各种临床表现的发生频率及辅助检查结果。结果诊断为POTS的患儿60例,其中男20例,女40例,男女比为1∶2,年龄8~12岁,平均(10±2)岁,8例具有家族遗传性,为13.3%。在直立试验(先安静平卧10mim,然后直立10min)或直立倾斜(HUT)试验过程中,POTS患儿最常见的异常表现为在直立或倾斜后10min内,心率增加≥35次/min,或患儿心率最大值≥120次/min,但血压下降<20/10mm Hg为诊断标准。出现异常表现的时间平均为(7±2)min,15例直立6min出现异常症状,10例在直立后即可出现异常症状,15例作HUT约10min内出现异常症状。结论POTS常见于学龄期女童,有一定的遗传性,常见的症状为头晕、胸闷、心慌等,HUT为诊断POTS敏感且重要的方法。
Objective To investigate the clinical features of children with orthostatic tachycardia syndrome (POTS). Methods Sixty children with POTS diagnostic criteria were selected as study objects. The age distribution, family genetic characteristics and hemodynamic parameters were analyzed. The frequency of occurrence of various clinical manifestations and the results of laboratory tests were also observed. Results There were 60 children diagnosed as POTS, including 20 males and 40 females. The ratio of male to female was 1: 2. The age ranged from 8 to 12 years (mean, 10 ± 2 years). The 8 patients had familial heredity of 13.3% . The most common abnormalities in children with POTS during upright (10 mim, then 10 min, upright) or upright tilt (HUT) tests were an increase in heart rate ≥35 beats / min within 10 minutes of standing or tilting or Children with heart rate ≥ 120 times the maximum / min, but decreased blood pressure <20 / 10mm Hg as diagnostic criteria. The average time of abnormal performance was (7 ± 2) min, abnormal symptoms were observed in 15 cases in 6 minutes after erection, abnormal symptoms in 10 cases after erection, and abnormal symptoms in 15 cases in about 10 minutes. Conclusions POTS is common in school-age girls and has a certain degree of heredity. The common symptoms are dizziness, chest tightness and palpitation. HUT is a sensitive and important method for POTS diagnosis.