摘要
目的探讨制定一种有效、简便、廉价的初筛评分方法用于儿童及青少年直立不耐受（0I）的诊断。方法选择2016年7月至2017年3月首次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、头晕、头痛、胸闷、胸痛、叹气等具有0I症状的儿童及青少年274例，其中男141例，女133例；年龄5～18岁[（11．8±2．7）岁]。每例患儿完成OI问卷调查表及直立倾斜试验（HUTT）。将心悸、头痛、冷汗、视物模糊或黑朦、胸闷、头晕、消化道症状、晕厥8项OI症状的各单项症状得分之和作为OI症状评分。应用SPSS18．0软件进行统计学分析。结果根据HUTT结果分为HUTT阳性组（123例）和HUTF阴性组（151例）。HUTT阳性组中血管迷走性晕厥（VVS）88例、体位性心动过速综合征（POTS）33例、直立性高血压（OHT）2例，包括31例基础直立倾斜试验（BHUT）阳性和92例舌下含化硝酸甘油倾斜试验（SNHUT）阳性。HUTT阳性组的0I症状得分明显高于HUTT阴性组[（6．4±4．6）分比（3．5±3．4）分，P=0．000]，差异有统计学意义。以评分≥2．5分为界值对HUTT阳性和HUTT阴性结果进行预测的灵敏度和特异度分别为79．2％、50．3％。由于分数为整数，所以当评分≥3分时，HUTT结果为阳性可能性大。HUTT阳性组中POTS组得分明显高于VVS组[（8．8±5．2）分比（5．5±4．1）分，P〈0．01]，而VVS组中以混合型得分最低；BHUT阳性组的得分明显高于SNHUT阳性组[（7．8±4．6）分比（5．6±4．4）分，P〈0．05]，差异均有统计学意义。结论0I症状评分对HulTr结果有一定预测价值，可作为0I的初筛工具。
Objective To design an effective, inexpensive and handy scoring system of preliminary screening for the diagnosis of orthostatic intolerance （ OI ） in children and adolescents. Methods Two hundred and seventy - four children or adolescents diagnosed or hospitalized in Children＇s Syncope Specialist Clinic or Inpatient Department of the Second Xiangya Hospital of Central South University from July 2016 to March 2017 ,who were complaining about the following symptoms like unexplained syncope, dizziness, headache, chest tightness, chest pain, etc. The 274 cases in- cluded 141 males and 133 females aging from 5 to 18 years old with a mean age of （ ll. 8 _＋2.7） years. Each patient was asked to finish OI questionnaire and head - up tilt test （ HUTF）. The scores of the eight symptoms,including palpi- tation, headache,profuse perspiration, blurred vision or amaurosis, chest tightness, dizziness, gastrointestinal symptoms and syncope,were added as OI symptom scores. The data were analyzed by SPSS 18.0 software. Results All the pa- tients were divided into HUTT negative group （ n = 151 ） and positive group （ n = 123 ）. The positive group was com- posed of vasovagal syncope （VVS） （n = 88） ,postural orthostatic tachyeardia syndrome （POTS） （ n = 33 ） and orthostatic hypertension （OHT） （n = 2）. Among them,31 cases were positive in baseline HUTT （BHUT） and 92 cases were negative in sublingual nitroglycerin - provocated HUTT （ SNHUT）. The mean OI symptom scores of HUTF positive group were distinctly higher than those of negative group [ （ 6.4 ± 4.6） scores vs. （ 3.5 ± 3.4） scores, P = 0. 000] with significant difference. Taking score ≥ 2.5 as the borderline, the sensitivity and specificity of HUTT result prediction were 79.2% and 50.3% ,respectively. Since the score was supposed to be integer number, HUTT resuh should be considered as positive when the score was ≥ 3. In the HUTT positive group, the scores of POTS children group were significantly higher than th
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2018年第1期28-31,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
湖南省自然科学基金（2016JJ2167）
中南大学中央高校基本科研业务费专项资金（2015zzts312）
湖南省发展改革委员会课题（2015-83）
关键词
直立不耐受
症状评分
直立倾斜试验
儿童
青少年
Orthostatie intolerance
Symptom score
Head - up tilt test
Child
Adolescent
