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目的探讨儿童血管迷走性晕厥(VVS)基础状态与血清胰岛素(INS)及C肽(CP)的初步关系。方法2004-06～2007-04在中南大学湘雅二医院儿童晕厥专科门诊就诊或住院的不明原因晕厥或先兆晕厥儿童经直立倾斜试验(HUTT)诊断为VVS 79例(晕厥组),男31例,女48例,平均年龄(11.18±2.47)岁。匹配健康儿童11例为对照(对照组),男5例,女6例,平均年龄(9.59±2.47)岁。全部研究对象在基础状态下抽取空腹8～10 h静脉血5 mL,应用日本HITA-CHI公司日立7600-020全自动生化分析仪采用己糖激酶法测定空腹血糖(FPG),美国Bayer公司ADVIA Centaur全自动免疫分析仪采用化学发光法检测INS及CP。结果晕厥组基础状态下FPG、INS、CP较对照组稍降低(P>0.05);HUTT阳性组FPG、INS、CP较HUTT阴性组稍增加(P>0.05);晕厥组中临床有晕厥病史者(n=55)按晕厥发作频次比较,晕厥频次≥4次组FPG、INS、CP较<4次组稍降低(P>0.05)。结论儿童VVS基础状态下FPG、血清INS及CP变化不明显,其对晕厥触发无明显的预测价值。
Objective To investigate the relationship between basal state of vasovagal syncope (VVS) and serum insulin (INS) and C-peptide (CP) in children. Methods A total of 79 VVS (syncope group) and 31 males (n = 35) were diagnosed as syncope or threatened syncope by pediatric orthopedic specialist outpatient department at Xiangya Second Hospital of Central South University from June 2004 to April 2007. , 48 females, mean age (11.18 ± 2.47) years old. Eleven healthy children were matched as controls (control group), including 5 males and 6 females, with an average age of (9.59 ± 2.47) years. All subjects in the basic state to extract fasting 8 ~ 10 h venous blood 5 mL, Japan HITA-CHI Hitachi 7600-020 automatic biochemical analyzer using hexokinase method for the determination of fasting blood glucose (FPG), the United States Bayer ADVIA Centaur Automatic immunoassay analyzer using chemiluminescence detection of INS and CP. Results The levels of FPG, INS and CP in the syncope group were slightly lower than those in the control group (P> 0.05). FPG, INS and CP in the HUTT positive group were slightly higher than those in the HUTT negative group (P> 0.05) (n = 55). According to the frequency of syncope episodes, FPG, INS and CP of the group with syncope frequency≥4 were slightly lower than those of <4 groups (P> 0.05). Conclusion The changes of FPG, INS and CP in children with VVS are not obvious, which have no obvious predictive value on the trigger of syncope.