儿童一过性意识丧失基础疾病谱分析

The analysis of the underlying disease spectrum of transient loss of consciousness in children

目的 通过多中心、大样本的临床研究,分析儿童一过性意识丧失（transient loss of consciousness,TLOC）的基础疾病谱.方法 研究对象为1999年8月至2013年4月在北京、湖南、湖北、上海四地儿科晕厥门诊就诊或住院的1203例TLOC患儿,其中男559例,女644例,年龄2-18岁,平均（11.5±3.2）岁,从病因学角度分析,得出儿童晕厥的基础疾病谱.结果 1203例TLOC患儿中,1125例为晕厥患儿,占所有患儿的93.5％,78例为非晕厥患儿.在晕厥患儿中,血管迷走性晕厥（vasovagal syncope,VVS）最常见,共409例,占34.1％,其中VVS-血管抑制型（VVS-vasoinhibitory,VVS-Ⅵ）234例,是VVS最常见的血流动力学类型,其次为体位性心动过速综合征（postural orthostatic tachycardia syncope,rOTS）,共346例（28.8％）,直立性高血压（orthostatic hypertension,OHT）24例,占2.0％.结论 晕厥是引起儿童TLOC最常见的原因,而VVS是引起晕厥最常见的病因,VVS-血管抑制型是VVS最常见的血流动力学类型,OHT可以导致儿童晕厥.

Objective To analyze the underlying disease spectrum of transient loss of consciousness （TLOC） in children through a multi-center and large sample chinical research.Methods The underlying disease spectrum of TLOC in 1203 children （559 male and 644 female children,aged 2-18 yrs,mean age 11.5 ±3.2 yrs） who came from Beijing,Hunan province,Hubei province and Shanghai of China was explored from August 1999 to April 2013.Results In 1 203 children with TLOC,1 125 （93.5％）were children with syncope,and 78 （6.5％） were non-syncope.In children with syncope,234 （19.5％）were of VVS-vasoinhibitory type （VVS-Ⅵ）,346 （28.8％） POTS and 24 （2.0％）orthostatic hypertension （OHT）.Conclusion Syncope was the most common disease of TLOC in children.And the most common hemodynamic pattern of syncope was VVS,followed by POTS.In three different hemodynamic pattems of VVS,the most common pattern was VVS vasoinhibitory one.In addition,OHT might also result in syncope.