儿童体位性心动过速综合征临床诊断进展

Progress on clinical diagnosis of postural tachycardia syndrome in children

体位性心动过速综合征(POTS)作为一种儿童时期常见的自主神经系统疾病,以体位突然改变或长时间站立时出现心率异常增快及慢性直立不耐受症状(如头痛、胸闷或胸痛、疲劳、叹气、黑蒙或晕厥)为常见的临床特征。儿童POTS的诊断标准与成人存在差异,仍然以直立试验和直立倾斜试验作为有效的诊断工具。近几年文献报道儿童POTS诊断研究已取得显著进展,涉及人群年龄特点、疾病昼夜节律变化、基层医院适用开展的改良直立试验、利用生物学标志物对POTS进行鉴别诊断等。儿童POTS的早期快速诊断能帮助患儿进行及时干预,有利于预后的改善并提高其生活质量。

Postural tachycardia syndrome(POTS)is a common disease of the autonomic nervous system in childhood,characterized by sudden changes in posture or prolonged standing with abnormally rapid heart rate and chronic orthostatic intolerance such as headache,chest tightness or pain,fatigue,sighing,amaurosis,or syncope.The diagnostic criteria for POTS in children are different from those in adults,and the standing test and the head-up tilt test are still used as effective diagnostic tools.In recent years,it has been reported that significant progress has been made in the diagnosis of POTS in children,including characteristics of population age,changes of disease circadian rhythm,modify standing test applied in local hospitals,differential diagnosis of POTS by biological markers,etc.Early and rapid diagnosis of POTS in children can help children with timely intervention,which is conducive to the improvement of prognosis and quality of life.