儿童自主神经介导性晕厥诊断与治疗的生物学标志物研究进展

Research progress on biomarkers for diagnosis and treatment of neurally mediated syncope in children

血管迷走性晕厥(VVS)与体位性心动过速综合征(POTS)是自主神经介导性晕厥中最为常见的类型,学龄期儿童和青少年多发,严重影响患儿学习和生活质量,并因晕厥发作增加躯体意外伤害的风险。临床上VVS与POTS的症状非常相似,诊断有时难以区分。加之二者的发病机制不尽相同,予以经验性的药物治疗,疗效并不十分理想。因此探寻敏感、适宜的检测方法,以便能准确区分晕厥原因,并针对不同的发病机制选择合适的治疗方案,成为儿童晕厥诊治工作的重要课题。近年来通过对自主神经介导性晕厥患者机体生物学标志物的深入研究,在区分VVS与POTS,以及预测晕厥个体化治疗效果方面取得了很大进展,由此进一步促进了儿童晕厥的精准治疗。

Vasovagal syncope(VVS)and postural orthostatic tachycardia syndrome(POTS)are the most common types of neurally mediated syncope,which is prevalent in school-age children and adolescents,seriously affecting their daily life and learning quality,and increasing the risk of accidental injury due to syncope.Because the clinical signs of these two diseases are very similar,diagnosis between VVS and POTS can easily be confused,and the pathogenesis of these two is not the same,the curative effect of empirical treatment is not very ideal.Therefore,finding a sensitive and reliable method for differential diagnosis and formulating individualized treatment plans have become an urgent clinical need in pediatrics syncope.In recent years,pediatricians utilizing biomarkers for study on differentiating VVS from POTS and predicting individualized treatment outcomes have made significant progress,thus promoting the precise treatment of syncope in children.