摘要
目的:比较体位性心动过速综合征(POTS)晕厥患儿与非体位性心动过速综合征晕厥患儿体表12导联心电图P波离散度。探讨P波离散度作为心电学标志在体位性心动过速综合征患儿中的意义。方法:2016年7月至2018年1月对我院门诊晕厥患儿186例行基础直立倾斜试验(HUTT)。取单纯体位性心动过速阳性反应作为HUTT-POTS组,共45例,HUTT阴性反应作为HUTT-(-)组,共39例。体位性心动过速阳性反应标准:平卧时心率在正常范围,直立倾斜试验的10分钟内心率较平卧位增加大于等于40次/分和(或)心率最大值达到标准(6~12岁大于等于130次/分,13~18岁大于等于125次/分);同时收缩压下降幅度小于20 mm Hg,舒张压下降幅度小于10 mm Hg。测量两组患儿平卧位12导联心电图P波离散度(PWD,PWD=Pmax-Pmin)并比较。结果:HUTT-POTS组男性比例为51%。两组患儿年龄、性别、体重指数间差异无统计学意义。两组患儿平卧位收缩压、舒张压、心率间差异无统计学意义。PWD在HUTT-POTS组(35.22±9.53 ms)较HUTT-(-)组(15.5±6.47 ms)增高,P<0.01,两组患儿PWD差异有显著统计学意义。结论:PWD可以作为体位性心动过速综合征患儿自主神经功能紊乱的心电学标志。
Objective:In this study,we evaluated P-Wave Dispersion(PWD)in children with Orthostatic Tachycardia Syndrome(POTS).In order to discuss the significance of PWD as an electrocardiographic sign in POTS.Methods:A total of 186 outpatient children with history of syncope were recruited in this study from July 2016 to January 2018 in our hospital.Among them,84 children were divided into two groups based on the results of head-up tilt testing(HUTT).45 children who were diagnosed with POTS by HUTT were selected to constitute HUTT-POTS group.39 children with HUTT negative served as the HUTT-(-)group.Positive response criteria for Postural Tachycardia:Heart rate in normal range during supine position.The fastest heart rate increased more than 40 times per minute in the 10 minutes of the upright tilt test than in the supine position.Or the maximum heart rate is greater than standard.(≥130 BPM in age6-12;≥125 BPM in age 13-18).At the same time,the decease of systolic blood pressure is less than 20 mm Hg,while the decease of diastolic blood pressure is less than 10 mmHg.All standard 12-lead ECGs were obtained in both groups.Compare the PWD in two groups(PWD=Pmax-Pmin).Results:The proportion of male in the HUTT-POTS group was 51%.There were no statistical differences between HUTT-POTS group and HUTT-(-)group in age,sex ratio,Body Mass Index(BMI),supine blood pressure and supine heart rate.The difference value between the fastest heart rate of the first ten minutes after tilt and the heart rate in supine position was statistically different between 2 groups.Mean PWD values were 35.22±9.53 ms,15.50±6.47 ms in HUTT-POTS group and HUTT-(-)group respectively.The PWD difference between two groups was statistically significant(P<0.01).Conclusion:We suggest that PWD could be an electrocardiographic sign of autonomic dysfunction in children with POTS.
作者
顾北音
傅立军
王红平
张海燕
屈顺梅
忻逸丽
GU Bei-yin;FU Li-jun;WANG Hong-ping;ZHANG Hai-yan;QU Shun-mei;XIN Yi-li(Department of Cardiology,Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,200127,China)
出处
《现代生物医学进展》
CAS
2019年第13期2460-2462,2493,共4页
Progress in Modern Biomedicine
基金
上海市科学技术委员会资助项目(10DZ1951200)
关键词
直立倾斜试验
体位性心动过速综合征
P波离散度
Head-up tilt testing
Postural orthostatic tachycardia syndrome
P-Wave Dispersion
