血浆内皮素配合描记动态脑电图在儿童晕厥诊断中应用的临床意义

摘要 目的：探究血浆内皮素配合描记动态脑电图在儿童晕厥诊断中的应用意义。方法：选择2017年1月至2020年1月于我院接受治疗的83例存在晕厥风险儿童，采集其静脉血样进行血浆内皮素水平测定，并实施动态脑电图检测，而后以倾斜试验结果为金标准，分别分析单纯血浆内皮素、单纯动态脑电图以及血浆内皮素+动态脑电图对晕厥的诊断应用意义。结果：（1）83例入组儿童中阳性为68例，阴性为15例，血浆内皮素检测阳性51例，阴性32例，一致性为77.11 %，灵敏度为73.53 %，特异度为93.33 %，阳性预测值为98.04 %， 阴性预测值为43.75 %；（2）动态脑电图诊断一致性为78.31 %，灵敏度为80.88 %，特异度为66.67 %，阳性预测值为91.67 %，阴性预测值为43.48 %；（3）联合检测诊断一致性为93.98 %，灵敏度为94.12 %，特异度为93.33 %，阳性预测值为98.46 %，阴性预测值为77.78 %；（4）检测方式差异性比较发现，联合检测在一致性、灵敏度、阴性预测值方面明显优于血浆内皮素和动态脑电图检测，在特异度方面优于动态脑电图检测（P<0.05）。结论：血浆内皮素联合描记动态脑电图对儿童晕厥具有较好的诊断辅助价值，能够显著提高诊断的一致性、灵敏度和特异度。

Clinical Significance of Plasma Endothelin Combined with Tracing Dynamic Electroencephalogram in the Diagnosis of Syncope in Children

ABSTRACT Objective: To explore the significance of plasma endothelin combined with tracing dynamic electroencephalography in the diagnosis of syncope in children. Methods: 83 children with risk of syncope who were treated in our hospital from January 2017 to January 2020 were selected, their venous blood samples were collected for plasma endothelin level determination, and dynamic electroencephalogram detection was performed, followed by tilt The test results are the gold standard, and the significance of the diagnosis of syncope by plasma endothelin alone, dynamic ambulatory electroencephalography and plasma endothelin+ambulatory electroencephalography is analyzed separately. Results: (1) Of the 83 children enrolled, 68 were positive, 15 were negative, 51 were positive for plasma endothelin, and 32 were negative. The consistency was 77.11 %, the sensitivity was 73.53 %, and the specificity was 93.33 %. The positive predictive value was 98.04 %, and the negative predictive value was 43.75 %.(2) The diagnostic consistency of dynamic electroencephalogram was 78.31 %, sensitivity was 80.88 %, specificity was 66.67 %, positive predictive value was 91.67 %, and negative predictive value 43.48 %. (3) The diagnostic consistency of the combined test was 93.98 %, the sensitivity was 94.12 %, the specificity was 93.33 %, the positive predictive value was 98.46 %, and the negative predictive value was 77.78 %. The combined detection is significantly better than plasma endothelin and dynamic EEG detection in terms of consistency, sensitivity and negative predictive value, and better than dynamic EEG detection in specificity. Conclusion: Plasma endothelin combined with electroencephalography has good diagnostic value for children with syncope, and can significantly improve the consistency, sensitivity and specificity of diagnosis.