Chen Li, Li Xueying, Todd Ochs, Wang Cheng, Jin Hongfang, Du Junbao
1Department of Pediatrics,Peking University First Hospital,Beijing,China.
2Department of Statistics,Peking University First Hospital,Beijing,China.
Cardiol Young. 2014 Aug;24(4):649-53. doi: 10.1017/S1047951113000929. Epub 2013 Jul 18.
At present, the haemodynamic diagnosis of orthostatic intolerance is based mainly on the head-up tilt table test, which is sometimes risky for patients. Thus, it is important to find objective and safe methods to differentiate haemodynamic patterns of orthostatic intolerance cases.
In all, 629 children with orthostatic intolerance, either vasovagal syncope or postural orthostatic tachycardia syndrome, were included in the multi-centre clinical study. We analysed the association between the clinical manifestation and haemodynamic patterns of the patients.
Syncope after motion with a prodrome of chest distress or palpitations and the concomitant symptom(s) after a syncopal attack, with debilitation, dizziness or headache, were the most important variables in predicting the diagnosis of vasovagal syncope. The overall diagnostic accuracy was 71.5%.
Complaint of syncope after motion with prodromal chest distress or palpitation and the concomitant symptom after a syncopal attack, with subsequent debilitation, dizziness or headache, were the most important variables in the diagnosis of vasovagal syncope in children with orthostatic intolerance.
目前，体位性不耐受的血流动力学诊断主要基于头高位倾斜试验，而该试验对患者有时存在风险。因此，找到客观且安全的方法来区分体位性不耐受病例的血流动力学模式很重要。
共有629例体位性不耐受儿童，包括血管迷走性晕厥或体位性直立性心动过速综合征患儿，被纳入这项多中心临床研究。我们分析了患者临床表现与血流动力学模式之间的关联。
运动后晕厥伴胸部不适或心悸前驱症状以及晕厥发作后的伴随症状（虚弱、头晕或头痛）是预测血管迷走性晕厥诊断的最重要变量。总体诊断准确率为71.5%。
运动后晕厥伴前驱性胸部不适或心悸的主诉以及晕厥发作后的伴随症状（随后出现虚弱、头晕或头痛）是体位性不耐受儿童血管迷走性晕厥诊断的最重要变量。
