儿童血管迷走性晕厥影响因素分析

牛少敏; 阎小娟; 王燕; 董童; 闵丽; 刘亚红; 李福轮; 董湘玉

doi:10.16835/j.cnki.1000-9817.2021.08.024

儿童血管迷走性晕厥影响因素分析

doi: 10.16835/j.cnki.1000-9817.2021.08.024

兰州大学第二医院小儿心血管科，甘肃 730030

基金项目:

兰州市科技计划项目 2017-4-90

详细信息

作者简介:
牛少敏(1985-)，女，陕西宝鸡人，硕士，主治医师，主要研究方向为儿童心血管疾病

通讯作者:
董湘玉，E-mail：dxy0223@163.com

中图分类号: R179 R445 R725.4
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- 被引次数: 0
出版历程
- 收稿日期: 2020-12-23
- 修回日期: 2021-03-20
- 网络出版日期: 2021-08-20
- 刊出日期: 2021-08-25

Analysis of risk factors for vasovagal syncope in children

Department of Pediatric Cardiology, Second Hospital of Lanzhou University, Lanzhou(730030), China

摘要

摘要: 目的分析儿童血管迷走性晕厥(VVS)发作的相关因素，为VVS早期预防、早期诊断、早期治疗提供一定的依据。方法收集2018年10月至2019年9月在兰州大学第二医院小儿心血管科住院的126例晕厥患儿为研究对象，经直立倾斜试验(HUTT)确诊为血管迷走性晕厥73例儿童为VVS组，另外53例儿童为对照组，回顾性调查其相关因素。结果 VVS组与比较组在年龄分布上差异有统计学意义(χ²=12.22，P<0.05)，VVS组有家族史、有晕厥史、有持久站立诱因、心电图异常、维生素D缺乏构成比(43.84%，31.51%，47.95%，34.25%，30.14%)与对照组(15.09%，13.21%，20.75%，15.09%，9.43%)比较，差异均有统计学意义(χ²值分别为11.71，5.67，9.79，5.83，7.82，P值均<0.05)。多因素Logistic回归分析显示，年龄、家族史与患VVS呈正相关(OR值分别为3.13，11.06，P值均<0.05)。方法年龄、家族史与VVS的发作相关。应积极关注患儿高危因素，早识别、早诊断，以预防儿童VVS的发生发展。
- 晕厥, 血管迷走神经性 /
- 回归分析 /
- 儿童 /
- 病例对照研究
Abstract: Objective To analyze the related factors of the onset of vasovagal syncope (VVS) in children, and to provide basis for the early prevention, early diagnosis and early treatment of VVS. Methods A total of 126 children with syncope admitted to Department of Pediatric Cardiology, Second Hospital of Lanzhou University from October 2018 to September 2019 were invited in the study. Totally 73 cases of children diagnosed with VVS by HUTT were selected as VVS group, and 53 HUTT-negative children were selected as control group. Related factors were retrospectively investigated, and risk factors for VVS were analyzed by univariate and multivariate regression. Results The VVS group showed statistically significant difference in age distribution with the control group (χ²=19.22, P<0.05). The VVS group showed statistically significant differences of proportion in family history, syncope history, prolonged standing, electrocardiogram abnormalities, and vitamin D deficiency (43.84%, 31.51%, 47.95%, 34.25%, 30.14%) compared with the control group (15.09%, 13.21%, 20.75%, 15.09%, 9.43%) (χ²=11.71, 5.67, 9.79, 5.83, 7.82, P<0.05). Multivariate Logistic regression analysis showed that age and family historywere risk factors for VVS(χ²=3.13, 11.06, P<0.05). Conclusion Age and family history may be risk factors for the onset of VVS. Active attention should be paid to the high-risk factors of child patient, early identification and diagnosis can prevent the occurrence and development of VVS in children.
- Syncope, vasovagal /
- Regression analysis /
- Child /
- Case-control studies

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表 1 一般情况分布在VVS组与对照组儿童间的比较

Table 1. Comparcomparison between VVS groups and control groups among children

一般情况	选项	VVS组(n=73)	对照组(n=53)	χ²值	P值
性别	男	32(43.84)	25(47.17)	0.14	0.71
	女	41(56.16)	28(52.83)
年龄/岁	6~9	16(21.92)	25(47.17)	12.22	0.00
	10~14	44(60.27)	16(30.19)
	≥15	13(17.81)	12(22.64)
营养状况	消瘦	32(43.84)	18(33.96)	1.37	0.50
	正常	23(31.51)	21(39.62)
	超重	18(24.66)	14(26.42)
首发时段	早晨	28(38.36)	18(33.96)	0.53	0.77
	中午	32(43.84)	23(43.40)
	晚上	13(17.81)	12(22.64)
家族史	有	32(43.84)	8(15.09)	11.71	0.00
	无	41(56.16)	45(84.91)
晕厥史	有	23(31.51)	7(13.21)	5.67	0.02
	无	50(68.49)	46(86.79)
持久站立诱因	有	35(47.95)	11(20.75)	9.79	0.00
	无	38(52.05)	42(79.25)
饮水量	少	27(36.99)	15(28.30)	1.51	0.47
	中	22(30.14)	21(39.62)
	多	24(32.88)	17(32.08)
心电图	异常	25(34.25)	8(15.09)	5.83	0.02
	正常	48(65.75)	45(84.91)
维生素D	缺乏	22(30.14)	5(9.43)	7.82	0.01
	正常	51(69.86)	48(90.57)
注：()内数字为构成比/%。

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表 2 儿童VVS多因素Logistic回归分析(n=126)

Table 2. Multivariate Logistic regression analysis of VVS among children (n=126)

自变量	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
年龄	1.17	0.34	11.69	<0.01	3.13(1.65~6.28)
家族史	2.40	0.52	18.73	<0.01	11.06(3.73~32.86)
维生素D缺乏	1.87	1.00	3.53	0.06	6.50(0.92~45.85)
晕厥史	1.08	1.80	0.36	0.55	0.34(0.01~11.67)
持久站立诱因	0.48	0.85	0.32	0.57	1.61(0.31~8.48)
心电图异常	2.54	0.78	0.31	0.08	11.37(0.77~25.75)

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