儿童血管迷走性晕厥反复发作相关因素分析

Analysis of the factors related to recurrent vasovagal syncope in children

目的 探讨影响儿童血管迷走性晕厥（VVS）反复发作的相关因素.方法 收集125 例确诊为VVS患儿的临床资料,根据晕厥首次发作至直立倾斜试验之前5 年内的发作次数,分为晕厥发作次数2、3 次的低频次组及≥ 4 次的高频次组,对两组患儿资料进行统计分析.结果 125例VVS患儿中,低频次组84 例（67.2%）,高频次组41 例（32.8%）.单因素分析结果显示,直立倾斜试验检查年龄、晕厥发作时间、发作诱因、晕车史、阳性家族史是VVS高频次发作的相关因素.非条件logistic 回归分析结果显示,发作诱因（OR = 3.723,95% CI ：1.163 - 11.918,P = 0.027）、晕车史（OR = 5.929,95% CI ：2.066 - 17.015,P = 0.001）、阳性家族史（OR = 6.794,95% CI ：2.006 - 23.013,P = 0.002）是VVS高频次发作的独立危险因素.结论 非持久站立引起的其他发作诱因、晕车史、阳性家族史对预测VVS患儿高频次晕厥发作具有重要临床意义.

Objective To explore the factors related to vasovagal syncope (VVS) in children. Methods The clinical data of 125 children with conifrmed VVS were collected. According to the frequency of syncope during the ifve years from ifrst episode to the time of head-up tilt test, the children with 2 or 3 episodes of syncope were assigned into the low episode group, and the children with 4 or more episodes of syncope were assigned into the high episode group. The two groups were analyzed and compared. Results Among the 125 children, 84 children (67.2%) were in the low episode group and 41 children (32.8%) were in the high episode group. The single factor analysis showed that the age at head-up tilt test, onset of syncopal, causes of syncope, history of carsickness, and positive family history were associated with high attack frequency. The results of non-conditional logistic regression analysis showed that causes of syncope (OR?=?3.723, 95%CI:1.163-11.918, P?=?0.027), history of carsickness (OR?=?5.929, 95%CI:2.066-17.015, P?=?0.001), and positive family history (OR?=?6.794, 95%CI:2.006-23.013, P?=?0.002) were the independent risk factors of high attack frequency. Conclusions The causes of syncope (excluding persistent standing), history of carsickness, and positive family history have important clinical signiifcance in predicting high attack frequency of VVS in children.