Chen Li, Zhang Chun-Yu, Du Jun-Bao
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2013 Oct 18;45(5):761-5.
To investigate the diagnostic values of heart rate varibility (HRV) on unexplained syncope (UPS) in children.
Forty-nine children with unexplained syncope underwent head-up tilt test (HUT) and Holter monitering, then the differences were analyzed between HUT positive children and HUT negative children. The receiver operating characteristic (ROC) curve was used to explore the diagnostic values of HRV.
Of the 49 patients, 32 (65.3%) were HUT positive. The diagnostic positive rate of HUT was 65.3%. The SDNNi, rMSSD, TP, ULF, VLF, LF and HF in the HUT positive group were significantly higher than those in the HUT negative group (P<0.05), respectively. There were no significant differences in SDNN, pNN50 and triangular index between the patients with different HUT outcomes (P>0.05). The ROC curve on the predictive values of SDNNi, rMSSD, TP, ULF, VLF, LF and HF showed that ULF, LF, and HF (12 947.00, 9 462.50, and 9 509.00) as cutting values produced both high sensitivity (75.0%, 68.8%, and 68.8%) and specificity (64.7%, 64.7%, and 64.7%) to predict the diagnostic values of HUT for diagnosing unexplained syncope.
ULF, LF and HF can be considered as indicators for diagnosing neurally-mediated syncope in children. ULF, LF, and HF (12 947.00, 9 462.50, and 9 509.00) taken as cutting values may produce both high sensitivity and specificity.
探讨心率变异性（HRV）对儿童不明原因晕厥（UPS）的诊断价值。
对49例不明原因晕厥患儿进行直立倾斜试验（HUT）和动态心电图监测，分析HUT阳性患儿与HUT阴性患儿之间的差异。采用受试者工作特征（ROC）曲线探讨HRV的诊断价值。
49例患者中，32例（65.3%）HUT阳性。HUT诊断阳性率为65.3%。HUT阳性组的SDNNi、rMSSD、TP、ULF、VLF、LF和HF均显著高于HUT阴性组（P<0.05）。不同HUT结果的患者之间SDNN、pNN50和三角指数无显著差异（P>0.05）。SDNNi、rMSSD、TP、ULF、VLF、LF和HF预测值的ROC曲线显示，以ULF、LF和HF（12947.00、9462.50和9509.00）为截断值时，对预测HUT诊断不明原因晕厥的诊断价值具有较高的敏感性（75.0%、68.8%和68.8%）和特异性（64.7%、64.7%和64.7%）。
ULF、LF和HF可作为儿童神经介导性晕厥的诊断指标。以ULF、LF和HF（12947.00、9462.50和9509.00）为截断值可能具有较高的敏感性和特异性。
