自主神经介导性晕厥儿童的心率变异性研究(附29例分析)

A study of heart rate variability in children with neurally mediated syncope

目的探讨自主神经介导性晕厥(NMS)患儿心率变异性的变化。方法2007年4月至2008年3月在北京大学第一医院儿科就诊的NMS患儿29例,其中男11例,女18例;年龄8～17岁,平均(12.4±2.2)岁。所有患儿进行24hHolter监测。比较患儿心率变异性中的各项参数变化。采用SPSS10.0软件进行统计。结果NMS组的窦性心搏间期标准差(SDNN)值与正常值相比,差异无统计学意义(P>0.05);窦性心搏间期标准差的均值(SDNNi)与正常值相比增加了19.21%(P<0.05),rMSSD值与正常值相比增加了54.07%(P<0.05),相邻的NN间期之差大于50ms的心搏数占总心搏数的百分率(pNN50)及三角指数值与正常值相比差异均无统计学意义(P>0.05)。结论NMS患儿存在自主神经功能调节失衡。

Objective To discuss the variation of parameters of heart rate variability in neurally mediated syncope （NMS） in children. Methods Twenty-nine children with NMS （11 males and 18 females, mean age 12.4±2.2 yrs） who came from Peking University First Hospital from April 2007 to March 2008, were included in the study. The hemodynamic patterns of NMS were detected. All patients experienced 24 hours of Holter monitoring. Parameters of heart rate variability in children with NMS were analyzed. SPSS 10.0 software was used for the statistical analysis of these data. Results There was no significant difference in SDNN between that of NMS group and normal value （P 〉 0.05）. The SDNNi and rMSSD in NMS group increased by 19.21% and 54.07%, respectively （P 〈 0.05）. The pNN50 and triangular index were not significantly different between NMS group and normal value （P 〉 0.05）. Conclusion There is autonomic nerve adjustment imbalance in children with NMS.