儿童血管迷走性晕厥与抑郁的关系

Relationship between vasovagal syncope and depression in children

目的探讨儿童血管迷走性晕厥（VVS）与抑郁的关系。方法2007-06-2007-11月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（USP）或先兆晕厥儿童84例，经直立倾斜试验（HUTT）检查诊断为VVS，男47例，女37例，年龄7-16岁，平均（11．01±2．00）岁。将VVS儿童分为HUTT阴性组（n=41）和HUTT阳性组（n=43），再将HUTT阳性组儿童依临床症状分为头晕组与晕厥组。所有受试儿童完成儿童抑郁障碍自评量表（DSRSC），用统计软件SPSS11．0进行数据分析。结果①“盼望美好事物”和“容易高兴起来”HUTT阳性组高于阴性组（P〈0．01），“生活没意思”HUTT阳性组低于阴性组（P〈0．05）。②“盼望美好事物”、“肚子痛”及“感到烦恼”得分HUTT阳性组高于常模组（P〈0．05或P〈0．01），“吃东西香”得分HUTT阳性组低于常模组（P〈0．05）。③“盼望美好事物”、“睡得很香”、“对自己有信心”和“容易高兴起来”得分HUTT阴性组低于常模组（P〈0．05或P〈0．01），“总是想哭”、“生活没意思”、“感到烦恼”得分及抑郁总分HUTT阴性组高于常模组（P〈0．05）。④HUTT阳性儿童“盼望美好事物”和“容易高兴起来”得分头晕组高于晕厥组（P〈0．05）。结论①儿童VVS抑郁发生率高。②VVS儿童较健康儿童食欲减少，躯体化症状、烦恼、抑郁情绪及信心丧失增多。③HUTT阳性儿童中，头晕组较晕厥组对生活更为乐观和积极。以上提示心理因素如抑郁在儿童VVS发生、发展、治疗及预后中可能起重要作用。

Objective To investigate the depression in the children with vasovagal syncope （VVS） , and to explore the relationship between VVS and depression in children. Methods 84 who came from syncope department and the hospitalization of the Second Xiangya Hospital of Central South University from June 2007 to November 2007 with unexplained syncope or prodromata [47 boys, 37 girls, aged 7 - 16 years old, mean （ 11.01 ± 2.00 ） years old ] were enrolled in this study. According to the result of head - up tilt table test （ HUTT ）, they were divided into HUTT - negative group （ n = 41 ） and HUTT- positive group （n = 43） , and according to the symptoms the patients in positive group were further divided into dizziness group and syncope group. All the subjects were asked to complete Depression Self - rating Scale for Children （ DSRSC ）. SPSS 11.0 software was used for the statistical analysis of these data. Results ①HUTr- positive group got a higher mark in ＂I look forward to things as much as I used＂ and ＂I am easily cheered up＂ than HUTT - negative group （P 〈0.01 ） , and got a lower mark in ＂I think life isnt worth living＂ （ P 〈0.05 ）.②HUTT - positive group got a higher mark in ＂I look forward to things as much as I used＂, ＂I get tummy aches＂ and ＂I feel very bored＂ than normal group （P 〈0.05 or P 〈0.01 ） , and got a lower mark in ＂I enjoy my food＂ （ P 〈0.05 ）. ③）HUT？ - negative group got a lower mark than normal group in ＂I look forward to things as much as I used＂, ＂I sleep very well＂, ＂I can stick up for myself＂ and ＂I am easily cheered up＂ （ P 〈0. 05 or P 〈0.01 ） , and got a higher mark in ＂I feel like crying＂, ＂I think life isnt worth living＂, ＂I feel very bored＂ and total scores of DSRSC （P 〈 0. 05 ）. ④dizziness group got a higher mark than syncope group of HUTT - positive group in ＂I look forward to things as much as I used＂ and ＂I am easily cheered up＂ （P 〈 0.05）. Conclusions ①Depression is common among VVS children. ②Compared with healthy children, the syncope children get a bad appetite, but a more frequent somatization symptom, vexation, depression and losing confidence. ③In the children with HUIT positive result, the ones with the symptom of dizziness are more energetic and more confident in life than the ones with the symptom of syncope. In a word, psychological factors such as depression may play an important role in the origin, development, treatment and prognosis of VVS in children.