■血管迷走性晕厥(VVS)和心理性假性晕厥(PPS)很难区分,鉴于他们相似的临床表现。本研究旨在探讨儿茶酚胺水平在儿童VVS和PPS鉴别诊断中的临床价值。
这项回顾性病例对照研究的数据来自于2021年3月至2023年3月期间在河北省儿童医院进行的VVS和PPS患儿的平视倾斜测试(HUTT)。收集的数据是基线临床特征,HUTT结果,仰卧位和直立位的血清儿茶酚胺水平,和24小时尿儿茶酚胺浓度。在VVS和PPS组之间比较这些变量。
■来自328个可能符合条件的案件,分析包括54例(16.46%)VVS和24例(7.32%)PPS。年龄无显著差异,性别,身体质量指数,在VVS组和PPS组之间观察到晕厥频率。晕厥的主要诱发因素是VSS组的体位变化(83.33%)和PPS组的情绪变化(41.67%)。VSS组的发作持续时间明显短于PPS组(4.01±1.20vs.24.06±5.56min,p<0.05)。VVS组的恢复时间也短于PPS组(1.91±0.85vs.8.62±2.55分钟,p<0.05)。相对于PPS患者,那些患有VVS的人在直立位置有明显更高的血清肾上腺素(EP)水平[199.35(102.88,575.00)与147.40(103.55,227.25),p<0.05]和较低的血清肾上腺素水平在仰卧位[72.70(42.92,122.85)vs.114.50(66.57,227.50),p<0.05]。
■血清EP水平在VVS和PPS的鉴别诊断中具有潜在价值。
UNASSIGNED: Vasovagal syncope (VVS) and psychogenic pseudosyncope (PPS) can be difficult to distinguish, given their similar clinical presentations. This study was conducted to explore the clinical value of catecholamine levels in the differential diagnosis of VVS and PPS in children.
UNASSIGNED: This retrospective case-control study was conducted with data from children with VVS and PPS who underwent head-up tilt tests (HUTTs) at the Children\'s Hospital of Hebei Province between March 2021 and March 2023. The data collected were baseline clinical characteristics, HUTT results, serum catecholamine levels in the supine and upright positions, and 24 h urinary catecholamine concentrations. These variables were compared between the VVS and PPS groups.
UNASSIGNED: From 328 potentially eligible cases, 54 (16.46%) cases of VVS and 24 (7.32%) cases of PPS were included in the analysis. No significant difference in age, sex, body mass index, or syncope frequency was observed between the VVS and PPS groups. The main predisposing factors for syncope were body position changes in the VSS group (83.33%) and emotional changes in the PPS group (41.67%). The episode duration was significantly shorter in the VSS group than in the PPS group (4.01 ± 1.20 vs. 24.06 ± 5.56 min, p < 0.05). The recovery time was also shorter in the VVS group than in the PPS group (1.91 ± 0.85 vs. 8.62 ± 2.55 min, p < 0.05). Relative to patients with PPS, those with VVS had significantly higher serum epinephrine (EP) levels in the upright position [199.35 (102.88, 575.00) vs. 147.40 (103.55, 227.25), p < 0.05] and lower serum epinephrine levels in the supine position [72.70 (42.92, 122.85) vs. 114.50 (66.57, 227.50), p < 0.05].
UNASSIGNED: Serum EP levels have potential value in the differential diagnosis of VVS and PPS.