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目的 探讨不明原因晕厥患儿在直立倾斜试验中血流动力学反应模式及构成比例。方法 对 2 0 0 1年1月至 2 0 0 3年 12月北京大学第一医院儿科收治的 90例不明原因晕厥患儿在安静环境下进行直立倾斜试验或硝酸甘油激发的直立倾斜试验 ,持续监测患儿心率和血压变化。结果 90例不明原因晕厥患儿直立倾斜试验中 ,经典的血管迷走性反应者 4 9例 ( 5 4 4 % ) ,其中血管抑制型 33例 ( 36 7% ) ,心脏抑制型 6例 ( 6 7% ) ,混合型 10例( 11 1% )。正常直立反应者 12例 ( 13 3% ) ,体位性心动过速反应者 2 8例 ( 31 1% ) ,直立性低血压反应者 1例( 1 1% ) ,没有发现自主神经反应障碍型及心脏变时功能障碍型。结论 不明原因晕厥患儿在直立倾斜试验中以经典的血管迷走性反应为主 ,其次为体位性心动过速综合征的反应 ,还可能出现体位性低血压等其他的异常血流动力学变化
Objective To investigate the hemodynamic patterns and their proportions in children with unexplained syncope in upright tilt test. METHODS: From January 2001 to December 2003, 90 children with unexplained syncope in the pediatric department of Peking University First Hospital underwent orthostatic tilt test or nitroglycerin-induced upright tilt test in quiet environment, Monitoring children with heart rate and blood pressure changes. Results Ninety-nine cases (54.4%) of the classic vasovagal responses in 90 children with unexplained syncope were observed in the tilt-tilt test, including 33 (36.7%) of the vasoconstrictive and 6 %), Mixed type in 10 cases (11 1%). There were 12 cases (13.3%) of normal upright responders, 28 cases (31.1%) of orthostatic tachycardia responders and 1 case (1 1%) of orthostatic hypotensive patients. No autonomic nerve dysfunction and Heart change dysfunction type. Conclusions Children with unexplained syncope have a predominantly vasovagal reaction in upright tilt test followed by response to orthostatic tachycardia syndrome and may have other abnormal hemodynamic changes such as orthostatic hypotension