儿童血管迷走性晕厥与QT间期离散度及心率变异性分析

Analyses of QT interval dispersion and heart rate variability in children with vasovagal syncope

目的探讨儿童血管迷走性晕厥(VVS)与QT间期离散度(QTd)及心率变异性(HRV)的变化。方法采用12导联同步心电图及动态心电图对52例VVS患儿及30例健康儿童的QTd及HRV进行测量。结果VVS患儿QTd,校正QT间期离散度和最长QT间期较对照组显著增人,具有显著性差异;直立倾斜试验(HUTT)阳性组和阴性组间QTd值比较无显著差异性。SDNN、SDANN及RMDNN病例组较对照组减小,且病例组SDNN、RMDNN与对照组相比有显著差异性;HUTT阳性组和阴性组间HRV无显著差异。结论VVS的发病机制与交感神经和副交感神经调节障碍有关。HUTT作为诊断VVS的金标准,其阴性者不能除外VVS。QTd、HRV对VVS患儿发生心肌缺血、心律失常等心血管事件具有一定的预测价值。

Objective To probe the changes of QT interval dispersion （QTd） and heart rate variability （HRV） in children with vasovagal syncope （VVS） . Methods 12 leads synchronous electrocardiogram and dynamic electrocardiogram were used to measure the OTd and HRV in 52 children with vasovagal syncope and in 30 healthy children. Results Compared with the control group, OTd, OTdc and QTmax increased in children wih VVS, and the differences were significant. There SDNN, SDANN and RMDNN decreased in VVS group, compared with the control, and the differences of SDNN and RMDNN were significant. Conclusion The nosogenesis of VVS related with the accommodation of disturbance of sympathetic nerve and parasympathetic nerve.