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目的探讨自主神经功能检测对体位性心动过速综合征(POTS)的诊断价值。方法对POTS患儿26例和健康儿童20例分别测定其瓦式(Valsalva)比值、深呼吸心率差、30 s最长RR间期/15 s最短RR间期(30/15)比值、卧立位血压差等自主神经功能及12导联同步体表心电图(12 ECG)QT间期离散度(QTd)、P波离散度(Pd)水平的变化。采用SPSS 13.0软件进行统计学分析。结果 POTS患儿Valsalva比值、深呼吸心率差与健康对照组比较[Valsalva比值:(1.08±0.06)vs(1.22±0.03);深呼吸心率差:(9.7±1.7)次.min-1 vs(18.3±1.6)次.m in-1]均明显降低,差异均有统计学意义(t=5.86、11.34,Pa<0.05)。与健康对照组比较,POTS患儿最大QT间期(QTmax)、最小QT间期(QTmin)、QTd延长(Pa<0.01),心率校正后最大QT间期(QTcmax)、心率校正后QT间期离散度(QTcd)增大(Pa<0.01,<0.05),而心率校正后最小QT间期(QTcm in)二组比较无统计学差异;二组最大P波时间(Pmax)、最小P波时间(Pm in)、心率校正后最大P波(Pcmax)、心率核正后最小P波(Pcm in)、Pd及心率校正后P波离散度(Pcd)比较,差异均无统计学意义(Pa>0.05)。结论 POTS患儿自主神经明显受损,Valsalva比值、深呼吸心率差、QTd可作为诊断POTS的一种新方法。
Objective To investigate the diagnostic value of autonomic nerve function test on orthostatic tachycardia syndrome (POTS). Methods Twenty-six POTS children and 20 healthy children were tested for Valsalva ratio, deep breathing rate difference, the longest RR interval of 30 s / 15 s RR interval (30/15), the lying position Blood pressure difference and other autonomic nervous function and 12-lead synchronous ECG (12 ECG) QTd, P wave dispersion (Pd) level changes. SPSS 13.0 software was used for statistical analysis. Results The Valsalva ratio and deep-breathing heart rate difference in POTS children were significantly lower than those in healthy controls [Valsalva ratio (1.08 ± 0.06) vs (1.22 ± 0.03) vs deep breathing heart rate difference: (9.7 ± 1.7) ) Times .m in-1] were significantly lower, the differences were statistically significant (t = 5.86,11.34, Pa <0.05). Compared with the healthy control group, the maximum QTmax, QTmin, QTd prolongation (P <0.01), QTcmax after heart rate correction, QT interval after heart rate correction (QTcd) increased (Pa0.01, <0.05), while QTcm in heart rate had no significant difference between the two groups; the maximum P wave time (Pmax), the minimum P wave time (Pm in), Pmax (Pmax) after heart rate correction, Pcmin after heart rate (Pcmin), Pd (Pcd) after heart rate correction, there was no significant difference (Pa> 0.05). Conclusions Autonomic nerve damage, Valsalva ratio, deep breathing heart rate difference and QTd can be used as a new method to diagnose POTS.