基础状态下空腹血糖与儿童直立倾斜试验结果的关系

The relationship of fasting glucose in basic state with the results of head-up tilt table test in children

目的 探讨基础状态下空腹血糖与儿童直立倾斜试验（head-up tilt table test,HUTT）结果的关系.方法 收集2012年9月至2013年2月在我院儿童晕厥专科门诊就诊或住院的不明原因晕厥、头痛、头晕、胸闷、叹气等儿童157例,男86例,女71例,年龄3 ～18岁,平均（11.34±3.29）岁.在排除器质性心脑血管疾病及其他原因所致上述症状,取得受试者或监护人书面知情同意后,进行HUTT.HUTT前监测患儿基础状态下空腹微量血血糖.结果 （1） HUTT阴性组（n=63）与HUTT阳性组（n=94）之间空腹血糖差异未见统计学意义[（5.40 ±0.52） mmol/L vs （5.35±0.61） mmol/L,t=-0.590,P＞0.05].（2） 94例HUTT阳性儿童中心脏抑制型血管迷走性晕厥仅l例未纳入统计,血管抑制型血管迷走性晕厥（n=67）、混合型血管迷走性晕厥（n=10）及体位性心动过速综合征（n=16）之间空腹血糖未见组间差异[（5.34±0.54）mmol/L vs （5.07 ±0.64） mmol/L vs （5.49 ±0.81） mmol/L,P均＞0.05].（3） 67例血管抑制型血管迷走性晕厥儿童中基础直立倾斜试验（n=16）与舌下含化硝酸甘油倾斜试验（n=51）两种诱发方式的空腹血糖差异未见统计学意义[（5.32±0.54） mmol/L vs（5.35 ±0.55） mmol/L,t=0.166,P＞0.05].（4）空腹血糖＜5.5 mmol/L与≥5.5 mmol/L两组的HUTT阴性率[37.63％（35/93） vs43.75％（28/64）]和HUTT阳性率[62.37％ （58/93） vs 56.25％ （36/64）]差异未见统计学意义（x2 =0.585,P＞0.05）.结论 空腹血糖对儿童HUTT结果没有预测价值.

Objective To explore the relationship of fasting glucose in basic state with the results of head-up tilt table test （HUTT） in children.Methods We choosed 157 cases of children （male 86 and female 71） with unexplained syncope,headache,dizziness and sigh,they were 3 ～ 18 （11.34 ± 3.29） years old and were outpatients or had been hospitalized in the Second Xiangya Hospital of Central South University from Sep 2012 to Feb 2013.The HUTT were carried on after eliminate organic disease of heart,head,bloodvessel and other reasons caused by the above symptoms and obtain written informed consent from participants or guardian.Before HUTI,trace fasting glucose of children would be monitored in based condition.Results （1） Between HUTT negative group （n =63） and HUTT positive group （n =94）,there was no significant difference in fasting glucose [（5.40 ± 0.52） mmol/L vs （5.35 ± 0.61） mmoL/L,t =-0.590,P ＞ 0.05].（2） Only 1 case of heart inhibited type vasovagal syncope did not be included in 94 children with HUTT positive.There were no significant differences in fasting glucose between vascular inhibited type vasovagal syncope （n =67） and mixed vasovagal syncope （n =10） and orthostatic tachycardia syndrome （n =16）[（5.34 ±0.54） mmol/L vs （5.07 ±0.64） mmol/L vs （5.49 ±0.81） mmol/L,P ＞0.05].（3） Among 67 cases of vascular inhibitory type vasovagal syncope in children,two kinds induced way of based tilt table test （n =16） and sublingual nitroglycerin tilt table test （n =51） showed no significant differences in fasting glucose [（5.32 ±0.54） mmol/L vs （5.35 ±0.55） mmol/L,t =0.166,P ＞0.05].（4） In two groups of fasting glucose ＜5.5 mmol/L and ≥5.5 mmol/L,HUTT negative rate [37.63％ （35/93） vs 43.75％ （28/64）] and HUTT positive rate [62.37％ （58/93） vs 56.25％ （36/64）] showed no statistical significance （x2 =0.585,P ＞ 0.05）.Conclusion Fasting glucose in basic state has no predictive value to HUTT results in children.