动态血压负荷与儿童直立倾斜试验结果的关系

The relationship of ambulatory blood pressure load with head-up tilt test results in children

目的探讨动态血压负荷与儿童直立倾斜试验（head—up tilt test，HuTT）结果的关系。方法选择2008年8月至2013年2月在中南大学湘雅二医院儿童晕厥专科就诊或住院的以不明原因晕厥或先兆晕厥为主诉的儿童311例，年龄3～17岁，男153例，女158例，行HUTT及24h动态血压检查。按血压负荷分为〈10％及≥10％两组。结果血压负荷在〈10％组及≥10％组，全天平均收缩压负荷[65．35％（132／202）VS59．63％（65／109），X^2=0．992，P〉0．05]、全天平均舒张压负荷[65．37％（168／257）vs 53．70％（29／54），X^2=2．607，P〉0．05]、日间平均收缩压负荷[65．48％（165／252）vs 54．24％（32／59），X^2=2．592，P〉0．05]、日间平均舒张压负荷[64．04％（187／292）VS52．63％（10／19），X^2=0．997，P〉0．05]、夜间平均收缩压负荷[66．30％（122／184）VS59．05％（75／127），X^2=1．234，P〉0．05]、夜间平均舒张压负荷[64．35％（148／230） vs 60．49％（49／81），X^2=0．382，P〉0．05]对HUTT阳性结果预测未见统计学差异，对HUTT阳性反应类型的预测亦未见统计学差异（P〉0．05）。以HUTT结果为因变量、血压负荷为自变量，未能拟合出线性回归方程。结论血压负荷对HUTT结果没有预测价值。

Objective To explore the relationship of ambulatory blood pressure load with head-up tilt test （HUTr） results in children. Methods A total of 311 children （ 153 males, 158 females, age 3-17 years old） of unexplained syncope or pre-syncope were enrolled in this study, who came from children syncope outpatient department or inpatient department of the Second Xiangya Hospital of Central South University during Aug 2008 to Feb 2013. HUTT and 24 h ambulatory blood pressure were checked. The children were devided into 〈 10% group and ≥ 10% group according to the blood pressure load. Results There were no statistical differences in the blood pressure load 〈 10% and ≥ 10% group with the HUTT result in 24- hour mean systolic pressure load [65.35% （132/202） vs 59. 63% （65/109） ,X^2 =0. 992 ,P 〉0. 05] ,24-hour mean diastolic pressure load [ 65.37% （ 168/257 ） vs 53.70% （ 29/54 ）, X^2 = 2. 607, P 〉 0.05 ], daytime mean systolic pressure load E 65.48 % （ 165/252 ） vs 54. 24 % （ 32/59 ）, X^2 = 2. 592, P 〉 0. 05 ], daytime mean diastolic pressure load [ 64. 04% （ 187/292 ） vs 52. 63% （ 10/19 ）, X^2 = 0. 997, P 〉 0. 05 ], nighttime mean systolic pressure load [66. 30% （122/184） vs 59.05% （75/127） ,X^2 = 1. 234 ,P 〉0. 051 ,nighttime mean diastolic pressure load [64. 35% （148/230） vs 60. 49% （49/81）, X^2 = 0. 382, P 〉 0.05 ]. There was also no statistical difference in the blood pressure load 〈 10% and 1〉 10% group with the HUTT positive reaction type （ P 〉 0. 05 ）. The HUTT results as the dependent variable, the blood pressure load as the independent variable,it was not fitting a linear regression equation. Conclusion Blood pressure load on the HUTT result has no predictive value in children.