血液指标与儿童血管迷走性晕厥复发的关系
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摘要
目的探究实验室血液指标与儿童血管迷走性晕厥(VVS)复发的关系。方法回顾性分析2014年1月—2017年1月青海大学附属医院收治的82例VVS患儿临床资料,并分为复发组21例(患儿治疗后1年内情复发)和非复发组61例(患儿治疗后1年内无复发)。单因素和Logistic多因素分析患儿VVS复发相关因素。结果单因素分析结果显示,复发组患儿的体重指数(BMI)、血红蛋白(Hb)、血小板计数(PLT)及平均红细胞血红蛋白含量(MCH)高于非复发组(P<0.05);复发组中有晕车史和有阳性家族史的患儿所占比例较高(P<0.05)。Logistic多因素分析结果显示,高Hb、高PLT、高MCH、合并晕车史及合并阳性家族史为患儿VVS复发的危险因素(P<0.05)。结论实验室血液指标中Hb、PLT及MCH升高为患儿VVS复发的危险因素,且合并晕车史、合并阳性家族史患儿复发率也较高,应对该类患儿加强监控,以改善预后。
Objective To explore the relationship between laboratory blood parameters and recurrence of vasovagal syncope(VVS) in children. Methods The clinical data of 82 children with vasovagal syncope in our hospital from January 2014 to January 2017 were analyzed retrospectively. 21 cases of children relapsed within 1 year after treatment were divided into the recurrence group, and the other 61 children without recurrence within 1 year after treatment were divided into non-recurrence group. Univariate and Logistic multivariate were used to analyze relapse-related factors in children with VVS. Results The results of univariate analysis showed that the body mass index(BMI), hemoglobin(Hb), platelet count(PLT) and mean erythrocyte hemoglobin(MCH) in recurrence group were higher than those in non-recurrence group, but BMI was lower(P < 0.05). The proportion of children with motion sickness history and positive family history in recurrence group was higher than that in non-recurrence group,and the difference was statistically significant(P < 0.05). Logistic multivariate analysis showed that high Hb, high PLT, high MCH, history of motion sickness and positive family history were risk factors of recurrence of children with VVS(P < 0.05). Conclusions Increasing Hb, PLT and MCH are the risk factors of recurrence of children with VVS. The children with motion sickness and positive family history have high risk of recurrence. To improve the prognosis, we should strengthen the surveillance of these children.
Objective To explore the relationship between laboratory blood parameters and recurrence of vasovagal syncope(VVS) in children. Methods The clinical data of 82 children with vasovagal syncope in our hospital from January 2014 to January 2017 were analyzed retrospectively. 21 cases of children relapsed within 1 year after treatment were divided into the recurrence group, and the other 61 children without recurrence within 1 year after treatment were divided into non-recurrence group. Univariate and Logistic multivariate were used to analyze relapse-related factors in children with VVS. Results The results of univariate analysis showed that the body mass index(BMI), hemoglobin(Hb), platelet count(PLT) and mean erythrocyte hemoglobin(MCH) in recurrence group were higher than those in non-recurrence group, but BMI was lower(P < 0.05). The proportion of children with motion sickness history and positive family history in recurrence group was higher than that in non-recurrence group,and the difference was statistically significant(P < 0.05). Logistic multivariate analysis showed that high Hb, high PLT, high MCH, history of motion sickness and positive family history were risk factors of recurrence of children with VVS(P < 0.05). Conclusions Increasing Hb, PLT and MCH are the risk factors of recurrence of children with VVS. The children with motion sickness and positive family history have high risk of recurrence. To improve the prognosis, we should strengthen the surveillance of these children.
引文
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[7]萧钟波.闭环刺激双腔起搏器防治血管迷走神经性晕厥的疗效观察[D].广州:南方医科大学,2013.
[8]张文华,王成,许毅,等.口服补液盐[I]治疗神经介导性晕厥儿童血清及尿电解质的变化[J].中华实用儿科临床杂志,2016,31(13):978-981.
[9]张建新,牛丽丹,杨亚勤,等.实验室指标联合Blatchford评分对急性上消化道出血内镜介入治疗后再出血的预测价值[J].现代消化及介入诊疗,2016,21(3):379-382.
[10]毛建平,王莹,贾韬,等.重组人白细胞介素-11治疗重型再生障碍性贫血血小板减少的临床观察[J].中国现代医学杂志,2016,26(7):116-119.
[11]谢玉海,王学军.高原地区患者术前凝血功能特征及血栓弹力图评估凝血功能的价值研究[J].中国现代医学杂志,2017,27(17):80-83.
[12]陈勇,童希忠,梁应平,等.颈交感神经干离断对脓毒症大鼠凝血和纤溶功能的影响[J].临床麻醉学杂志,2015,31(9):908-911.
[13]蔡高军,翁伟进,师干伟,等.血管迷走性晕厥193例临床特征分析[J].实用医学杂志,2015,31(6):978-980.
[14]段泓宇,周开宇,王川,等.儿童晕厥临床特点与直立倾斜试验结果相关因素分析[J].中华儿科杂志,2016,54(4):269-272.
[2]CHU W H,CHENG W,WU L J,et al.Oral rehydration salts:an effective choice for the treatment of children with vasovagal syncope[J].Pediatric cardiology,2015,36(4):867-872.
[3]杜军保,蔺婧.儿童血管迷走性晕厥的诊断与治疗[J].中华实用儿科临床杂志,2014,29(1):1-2.
[4]HUMM,A M,Z’GRAGGEN W J.Venepuncture during head-up tilt testing in patients with suspected vasovagal syncope-implications for the test protocol[J].the Official Journal of the European Federation of Neurological Societies,2015,22(2):389-394.
[5]蔡高军,翁伟进,杨丽萍,等.114例女性血管迷走性晕厥患者的临床特征及转归情况分析[J].实用心脑肺血管病杂志,2015,23(6):75-77.
[6]徐萌,黄敏,沈捷,等.儿童血管迷走性晕厥反复发作相关因素分析[J].临床儿科杂志,2016,34(3):192-196.
[7]萧钟波.闭环刺激双腔起搏器防治血管迷走神经性晕厥的疗效观察[D].广州:南方医科大学,2013.
[8]张文华,王成,许毅,等.口服补液盐[I]治疗神经介导性晕厥儿童血清及尿电解质的变化[J].中华实用儿科临床杂志,2016,31(13):978-981.
[9]张建新,牛丽丹,杨亚勤,等.实验室指标联合Blatchford评分对急性上消化道出血内镜介入治疗后再出血的预测价值[J].现代消化及介入诊疗,2016,21(3):379-382.
[10]毛建平,王莹,贾韬,等.重组人白细胞介素-11治疗重型再生障碍性贫血血小板减少的临床观察[J].中国现代医学杂志,2016,26(7):116-119.
[11]谢玉海,王学军.高原地区患者术前凝血功能特征及血栓弹力图评估凝血功能的价值研究[J].中国现代医学杂志,2017,27(17):80-83.
[12]陈勇,童希忠,梁应平,等.颈交感神经干离断对脓毒症大鼠凝血和纤溶功能的影响[J].临床麻醉学杂志,2015,31(9):908-911.
[13]蔡高军,翁伟进,师干伟,等.血管迷走性晕厥193例临床特征分析[J].实用医学杂志,2015,31(6):978-980.
[14]段泓宇,周开宇,王川,等.儿童晕厥临床特点与直立倾斜试验结果相关因素分析[J].中华儿科杂志,2016,54(4):269-272.