The Comparison of the Ocular Compression Test and the Tilt-table Test in the Suspected Patient of Vasovagal Syncope in Children and Adolescence = 혈관미주신경성 실신이 의심되는 소아청소년 환자에서 기립경사검사와 안구압박검사의 유용성 비교

국문 초록 (Abstract)

목 적 : 혈관미주신경성 실신은 소아와 청소년에서 상대적으로 흔한 질환이다. 본 연구는 혈관미주신경성 실신이 의심되는 환자에서 기립경사 검사(tilt table test)와 안구압박 검사(ocular compression test)의 유용성을 비교하고자 하였다.
방 법 : 2009년 3월부터 2012년 3월까지 고려대학교 구로병원에 실신으로 내원한 환아 중 임상적으로 혈관미주신경성 실신이 의심되는 환자를 대상으로 기립경사 검사와 안구압박 검사를 모두 시행한 환자의 의무기록을 검색하였다. 기립성 저혈압, 기립성 빈맥 증후군 및 뇌전증으로 진단된 환자는 모두 제외하였다. 또한 혈구검사, 전해질 및 갑상선 기능 검사 등의 혈액검사를 통하여 기립경사검사와 안구 압박검사의 결과에 영향을 끼칠 수 있는 질환을 제외하였다.
결 과 : 본 연구 기간 동안 임상적으로 혈관미주신 경성 실신이 의심되는 환자는 46명이었다. 평균 연령은 13.6±3.1세(3–21세)였고, 그 중 남아는 15명(32.6%), 여아는 31명(67.4%)이었다. 전체 46명 환자 중 18명(39.1%)은 기립경사 검사에서 양성이었고, 31명(67.4%)은 안구압박 검사에서 양성이었다. McNemar 검정 상 P 값이 0.029로 통계학적으로 유의하였으며, 이는 두 검사간의 차이가 있다는 것을 의미한다. 또한 기립경사 검사에서 음성이었던 환자 중 안구압박 검사에서 양성인 환자는 22명이었다. 기립경사 검사를 하는 동안 43명(93.5%)의 환자가 구역, 구토, 어지러움, 유사 실신(near fainting) 등의 부작용으로 인하여 검사가 중단되었으나 안구압박 검사를 실시하는 동안에는 가벼운 안구통증 외에는 합병증이 없었다.
결 론 : 본 저자들은 상대적으로 안전하면서 정확한 검사인 안구압박검사가 소아 및 청소년의 혈관미 주신경성 실신을 진단하는데 있어 기립경사검사와 더불어 유용한 검사라고 판단된다.

다국어 초록 (Multilingual 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.

목차 (Table of Contents)

• Abstract
• Introduction
• Materials and methods
• Results
• Discussion
• 한글요약
• References

참고문헌 (Reference)

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