| 李静静,刘枭,陈洋,等.心率变异性和 QT间期离散度在血管迷走性晕厥中的诊断价值[J].安徽医药,2025,29(10):2032-2036. |
| 心率变异性和 QT间期离散度在血管迷走性晕厥中的诊断价值 |
| Diagnostic value of heart rate variability and QT interval dispersion in vasovagal syncope |
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| DOI：10.3969/j.issn.1009-6469.2025.10.024 |
| 中文关键词: 晕厥，血管迷走神经性 直立倾斜试验 心电描记术 心率变异性 QT间期离散度 儿童 |
| 英文关键词: Syncope,vasovagal Head-up tilt table test Electrocardiography Heart rate variability QT in-terval dispersion Child |
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| 中文摘要: |
| 目的探讨心率变异性( heart rate variability，HRV)和 QT间期离散度( QT interval dispersion，QTd)对血管迷走性晕厥(vasovagal syncope，VVS)病儿诊断效能。方法选取 2019年 9月至 2023年 5月因晕厥到徐州市中心医院儿童晕厥专病门诊就诊或住院，通过直立倾斜试验( head-up tilt table test，HUTT)明确诊断为的 VVS的儿童 69例为 VVS组，同时期在徐州市中心医院体检的健康儿童 69例为健康组。 VVS组和健康组均进行 24 h动态心电图和 12导联心电图检查。采用 SPSS 26.0统计软件进行数据处理。结果 VVS组标准差均值( SDNNi)、差值均方根( rMSSD)、低频功率( LF)、高频功率( HF)、极低频功率( VLF)高于健康组( P<0.05)。与健康组相比， VVS组最大 QT间期( QTmax)［( 407.10±32.58)ms比( 376.89±17.52)ms］、最小 QT间期(QTmin)［(364.26±26.36)ms比( 343.56±14.69)ms］、 QT间期离散度( QTd)［(40.86±9.61)ms比( 33.07±6.74)ms］、校正最大 QT间期( QTcmax)［( 458.17±29.80)ms比( 432.44±16.49)ms］、校正最小 QT间期( QTcmin)［( 410.53±24.78)ms比( 394.00±14.94)ms］、校正 QT间期离散度(QTcd)［(45.98±6.57)ms比( 39.17±7.04)ms］延长，差异有统计学意义(P<0.05)。绘制受试者操作者特征曲线( receiver operating characteristic curves，ROC曲线)，结果显示 VLF、QTd以及二者联合诊断的曲线下面积( AUC)分别为 0.80、 0.86、0.91，两种指标联合诊断的 AUC高于单个指标。结论 HRV部分指标和 QTd对预测 HUTT诊断儿童血管迷走性晕厥具有一定的价值， VLF联合 QTd能提高对 VVS的诊断效能。 |
| 英文摘要: |
| Objective To explore the diagnostic efficacy of heart rate variability (HRV) and QT interval dispersion (QTd) in childrenwith vasovagal syncope (VVS).Methods A total of 69 children, who visited Pediatric Syncope Center or were hospitalized in XuzhouCentral Hospital between September 2019 and May 2023 due to syncope and were diagnosed as VVS by head-up tilt table test (HUTT), were selected as VVS group, and 69 healthy children who visited Xuzhou Central Hospital for medical check-ups during the same period were selected as healthy control group. A 12-lead electrocardiogram and a 24-hour ambulatory electrocardiogram monitoring were per-formed for both VVS and healthy control groups. SPSS 26.0 was utilized to process the data.Results The mean of the SD of all NN inter-vals for all 5-minute segments (SDNNi), square root of the mean of the sum of squares of differences between adjacent NN intervals (rMS‐SD), low-frequency power (LF), high-frequency power (HF), and very low-frequency power (VLF) of the VVS group were higher than thoseof the healthy control group, and the differences were statistically significant (P<0.05). In the VVS group, the maximum QT interval (QT-max) [(407.10±32.58) ms vs. (376.89±17.52) ms], minimum QT interval (QTmin) [(364.26±26.36) ms vs. (343.56±14.69) ms], QT interval dispersion (QTd) [(40.86±9.61) ms vs. (33.07±6.74) ms], corrected maximum QT interval (QTcmax) [(458.17±29.80) ms vs. (432.44± 16.49) ms], corrected minimum QT interval (QTcmin) [(410.53±24.78) ms vs. (394.00±14.94) ms], and corrected QT interval dispersion (QTcd) [(45.98±6.57) ms vs. (39.17±7.04) ms] were prolonged with statistically significant differences when compared to the healthygroup (P<0.05). Receiver operating characteristic curves (ROC curves) were drawn for the subjects, and the results showed that the areas underthe curve (AUC) for VLF, QTd, and their combined diagnosis were 0.80, 0.86, and 0.91, respectively, and the AUC of the combined diag-nosis of the two indexes was higher than that of the single index.Conclusion Certain HRV indices and QTd are valuable in predictingHUTT for the diagnosis of vasovagal syncope in children, and VLF combined with QTd improves the diagnostic efficacy in VVS. |
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