혈관미주신경성 실신이 의심되는 소아청소년환자에서 기립경사검사와 안구압박검사의유용성 비교

Abstract

Purpose : Vasovagal syncope (VVS) is a relatively common disease in children and adolescence. The aim of this study was to compare the tilt-table test (TTT) and the ocular compression test (OCT) in patients who were clinically suspected to VVS. Methods : We searched the medical records of patients who were clinically suspected to VVS during the period from March 2009 to March 2012 at Korea University Guro hospital. Orthostatic hypotension, postural orthostatic tachycardia syndrome and epilepsy were excluded. We also analyzed complete blood test, electrolytes and thyroid function test to exclude other medical conditions that could potentially affect the result TTT or OCT. Results : Forty-six patients who were clinically suspected to VVS were selected. The mean age was 13.6±3.1 years (range, 3.21 years). Fifteen (32.6%) patients were males and thirty-one (67.4%) females. Among the selected patients, eighteen (39.1%) patients were TTT positive and thirty-one (67.4%) were OCT positive. In the McNemar’s test, the P value was 0.02 (P<0.05) which meant there was a difference between two tests to diagnose VVS. In addition, there were 22 patients who were positive for OCT and negative for TTT. During TTT, forty-three (93.5%) patients had to be stopped due to severe symptoms such as nausea, vomiting, dizziness and near fainting, but no patient had any complication during and after OCT. Conclusion : We suggest that OCT is a relatively safe and useful test for diagnosing patients with VVS in children and adolescence in addition to TTT.