体质量指数与儿童血管迷走性晕厥心脏抑制型反应时间的关系

The relationship between body mass index and response time of cardioinhibitory type vasovagal syncope in children

目的探讨体质量指数(BMI)与儿童血管迷走性晕厥心脏抑制型(VVS-CI)反应时间的关系。方法回顾性分析2012年12月至2019年9月因晕厥或晕厥先兆在中南大学湘雅二医院儿童晕厥专科门诊诊断为VVS-CI的56例患儿临床资料。根据身长、体质量计算体质量指数(BMI),分为低BMI组(35例)和正常BMI组(21例)。比较2组间基础心率、直立倾斜试验(HUTT)阳性反应时心率、基础直立倾斜试验(BHUT)阳性反应时间、舌下含化硝酸甘油直立倾斜试验(SNHUT)阳性反应时间。对BMI与阳性反应时间进行相关性分析。应用SPSS 22.0软件进行统计学分析。结果2组间年龄、性别、病程、晕厥频次比较差异均无统计学意义(均P>0.05)。2组间基础心率、阳性反应时心率比较差异均无统计学意义[(78.5±15.3)次/min比(72.8±8.7)次/min,t=1.223,P=0.230;(44.0±13.9)次/min比(47.0±10.0)次/min;t=-0.664,P=0.511]。低BMI组较正常BMI组BHUT阳性反应患儿/SNHUT阳性反应患儿比率增高(27/8例比9/12例,χ^(2)=4.839,P=0.027)、BHUT阳性反应时间短[(13.1±4.6)min比(23.7±9.5)min,t=-2.691,P=0.023]。2组间SNHUT阳性反应时间比较差异无统计学意义(P>0.05)。低BMI与BHUT阳性反应时间具有相关性(r=0.750,P=0.005)。正常BMI与BHUT阳性反应时间无相关性(r=0.316,P=0.217)。低BMI和正常BMI与SNHUT阳性反应时间均无相关性(r=0.177,P=0.431;r=0.021,P=0.940)。结论低BMI与儿童VVS-CI的BHUT阳性反应时间呈正相关。低BMI儿童出现心脏抑制反应的时间较正常BMI儿童短。

Objective To investigate the relationship between body mass index(BMI)and response time of cardioinhibitory type vasovagal syncope(VVS-CI)in children.Methods The clinical data of 56 children with syncope or pre-syncope were retrospectively analyzed and they visited specialist clinic for syncope and were diagnosed as VVS-CI in the Second Xiangya Hospital,Central South University from December 2012 to September 2019.Based on height and weight,BMI was calculated,and divided into low BMI group(35 cases)and normal BMI group(21 cases).Between the 2 groups,baseline heart rate,head-up tilt test(HUTT)positive response heart rate,baseline head-up tilt test(BHUT)positive response time,and sublingual nitroglycerin-provocated HUTT(SNHUT)positive response time were compared.The correlation between BMI and positive response time was analyzed.SPSS 22.0 software was applied for statistical analysis.Results There were no significant differences in age,sex,duration of disease and number of syncope between the 2 groups(all P>0.05).No significant differences were found in baseline heart rate and positive response heart rate between the 2 groups[(78.5±15.3)times/min vs.(72.8±8.7)times/min,t=1.223,P=0.230;(44.0±13.9)times/min vs.(47.0±10.0)times/min,t=-0.664,P=0.511].Compared with normal BMI group,BHUT positive patients/SNHUT positive patients were higher in low BMI group(27/8 cases vs.9/12 cases,χ^(2)=4.839,P=0.027),and the positive response time of BHUT was shorter[(13.1±4.6)min vs.(23.7±9.5)min,t=-2.691,P=0.023].There were no significant differences in SNHUT positive response time between the 2 groups(P>0.05).Low BMI was correlated with BHUT positive response time(r=0.750,P=0.005).Normal BMI was not associated with BHUT positive response time(r=0.316,P=0.217).There was no correlation between low BMI and normal BMI and SNHUT positive response time(r=0.177,P=0.431;r=0.021,P=0.940).Conclusions Low BMI is positively correlated with BHUT positive response time of children with VVS-CI.The time it takes for syncope occurrence was shorter in children with low BMI than that in normal BMI.