[头高位倾斜试验不同时间点心率及心率差值对儿童青少年体位性心动过速综合征的诊断效率]
[Efficiency of heart rate and heart rate difference at different time points during head-up tilt test in the diagnosis of postural tachycardia syndrome in children and adolescents].
作者信息
Wang Shuo, Zou Run-Mei, Cai Hong, Ding Yi-Yi, Xiao Hai-Hui, Wang Xin, Li Fang, Wang Yu-Wen, Wang Cheng
机构信息
Department of Pediatric Cardiovasology, Children's Medical Center, Second Xiangya Hospital, Central South University, Changsha 410011, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Jul;22(7):780-784. doi: 10.7499/j.issn.1008-8830.2003133.
OBJECTIVE
To study the efficiency of heart rate (HR) and heart rate difference (HRD) at different time points during head-up tilt test (HUTT) in the diagnosis of postural tachycardia syndrome (POTS) in children and adolescents.
METHODS
A total of 217 children and adolescents, aged 6-16 years, who were diagnosed with POTS were enrolled as the POTS group, and 73 healthy children and adolescents, matched for sex and age, were enrolled as the control group. The POTS group was further divided into ≤12 years old group with 127 children/adolescents and >12 years old group with 90 children/adolescents. The two groups were compared in terms of HR at baseline and at 5 and 10 minutes of HUTT (HR0, HR5, and HR10 respectively), difference between HR5/HR10 and HR0 (HRD5 and HRD10 respectively). The efficiency of HR5, HR10, HRD5 and HRD10 in the diagnosis of POTS was assessed.
RESULTS
Compared with the control group, the POTS group had significant increases in HR5, HR10, HRD5, and HRD10 (P<0.05). The coincidence rate of HR or HRD for the diagnosis of POTS in males was higher than that in females at 5 minutes of HUTT (P<0.05), while the coincidence rate of HR or HRD for the diagnosis of POTS in males was lower than that in females at 10 minutes of HUTT (P<0.05). The coincidence rate of HR for the diagnosis of POTS was higher in the >12 years old subgroup (P<0.05), while the coincidence rate of HRD for the diagnosis of POTS was higher in the ≤12 years old subgroup (P<0.05). The combination of HR5, HR10, HRD5, and HRD10 for the diagnosis of POTS had a greater area under the curve (0.974; 95%CI: 0.949-0.989) than HR5, HR10, HRD5, or HRD10 alone, with a sensitivity of 87.80% and a specificity of 95.83%. The diagnostic efficacy of HRD for POTS was higher than that of HR (P<0.05).
CONCLUSIONS
HR and HRD at different time points during HUTT have a good value in the diagnosis of POTS in children and adolescents, and the accuracy of diagnosis varies with age and gender.
目的
研究儿童及青少年直立倾斜试验（HUTT）不同时间点的心率（HR）及心率差值（HRD）对体位性心动过速综合征（POTS）的诊断价值。
方法
选取217例6 - 16岁诊断为POTS的儿童及青少年作为POTS组，另选取73例年龄、性别匹配的健康儿童及青少年作为对照组。POTS组进一步分为≤12岁组（127例儿童/青少年）和>12岁组（90例儿童/青少年）。比较两组在基线、HUTT 5分钟及10分钟时的心率（分别为HR0、HR5和HR10），HR5/HR10与HR0的差值（分别为HRD5和HRD10）。评估HR5、HR10、HRD5和HRD10对POTS的诊断效能。
结果
与对照组相比，POTS组的HR5、HR10、HRD5和HRD10均显著升高（P<0.05）。HUTT 5分钟时，男性HR或HRD诊断POTS的符合率高于女性（P<0.05）；HUTT 10分钟时，男性HR或HRD诊断POTS的符合率低于女性（P<0.05）。>12岁亚组HR诊断POTS的符合率较高（P<0.05），≤12岁亚组HRD诊断POTS的符合率较高（P<0.05）。HR5、HR10、HRD5和HRD10联合诊断POTS的曲线下面积（0.974；95%CI：0.949 - 0.989）大于单独的HR5、HR10、HRD5或HRD10，敏感度为87.80%，特异度为95.83%。HRD对POTS的诊断效能高于HR（P<0.05）。
结论
HUTT不同时间点的HR及HRD对儿童及青少年POTS具有较好的诊断价值，且诊断准确性随年龄及性别而异。
Zotero 插件