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目的探讨儿童血管迷走性晕厥(VVS)直立倾斜试验(HUTT)中ECG的变化。方法选取本院门诊及住院晕厥患儿123例,经详细询问患儿病史,行体格检查、常规12导联ECG及头颅CT等一系列检查,疑诊VVS 65例。疑诊VVS患儿停用可能影响自主神经功能的饮食,停用血管活性药物5个半寿期以上(6～8 d),行HUTT或舌下含化硝酸甘油倾斜试验。结果 VVS患儿HUTT中可出现各种心律失常,以窦性心动过速多见[40例(61.5%)],结性逸搏心律次之[23例(35.4%)]。HUTT阳性类型:血管抑制型45例(69.2%),混合型16例(24.6%),心脏抑制型41例(6.2%)。结论 VVS儿童HUTT中可出现各种心律失常。VVS患儿应严密观察ECG变化,必要时积极干预,以免发生意外。
Objective To investigate the changes of ECG in children with vasovagal syncope (VVS) upright tilt test (HUTT). Methods A total of 123 children with syncope were selected from our hospital and hospitalized. 65 children with suspected VVS were examined by detailed examination of their children’s medical history, physical examination, routine 12-lead ECG and cranial CT. Suspected children with VVS may discontinue the diet that may affect autonomic nervous function, disable vasoactive drugs for more than 5 half-lives (6 to 8 days), perform HUTT or sublingual nitroglycerin tilt test. Results A variety of arrhythmias were found in HUTT in children with VVS, with sinus tachycardia more frequently [40 cases (61.5%)], followed by esophageal rhythm (23 cases [35.4%]). The positive type of HUTT was: 45 cases (69.2%) of vasohibition type, 16 cases (24.6%) of mixed type and 41 cases (6.2%) of cardiac inhibition type. Conclusion Various arrhythmias may occur in HUTT in children with VVS. VVS children should be closely observed ECG changes, if necessary, active intervention to avoid accidents.