选择性α1受体激动剂对儿童体位性心动过速综合征的治疗研究  

Effect of selective α1 receptor agonist in the treatment of children with posturai orthostatic tachycardia syndrome

作　　者：陈丽[1] 杜军保[1] 金红芳[1] 张清友[1] 李万镇[1] 汪立[2] 王瑜丽[1] 

机构地区：[1]北京大学第一医院儿科,100034 [2]北京大学医学部

出　　处：《中华儿科杂志》2008年第9期688-691,共4页Chinese Journal of Pediatrics

基　　金：国家十五科技攻关课题（2004BA720A10）;首都医学发展基金（2002-3037,2007-2003）

摘　　要：目的探讨选择性仅1受体激动剂盐酸米多君对体位性心动过速综合征（POTS）的治疗效果。方法本组55例，为2000年5月-2007年9月在北京大学第一医院就诊或住院的POTS患儿，其中男23例，女32例；年龄5—19岁，平均（12．3±3．1）岁，随机分为治疗组（应用盐酸米多君及口服补液盐治疗）22例和对照组（应用口服补液盐治疗）33例，对两组儿童进行临床研究及直立试验、基础直立倾斜试验（BHUT）或硝酸甘油激发直立倾斜试验（SNHUT）研究，比较治疗前后患者的好转率、HUT转阴率以及随访终点时的临床痊愈率和有效率。采用SPSS10．0软件进行统计。结果治疗3周和6周后治疗组的好转率均明显高于对照组（100．0％ vs 42．4％，P〈0．001；100．0％ vs 42．4％，X^2=19．352，P〈0．001），随访终点时治疗组的临床痊愈率明显高于对照组（77．3％ vs 27．3％，X^2=13．239，P〈0．001），有效率也明显高于对照组（100．0％ vs 36．4％，X^2=22．647，P〈0．001）。治疗3周后治疗组和对照组HUT转阴率相比差异无统计学意义（31．8％ vs 12．1％，P〉0．05）；治疗6周后治疗组的HUT转阴率明显高于对照组（81．0％ vs 48．5％，P〈0．05）。结论选择性α1受体激动剂盐酸米多君对POTS患儿的治疗有效。Objective The study was designed to examine the effect of selective ctl receptor agonist midodrine hydrochloride in the treatment of children with postural orthostatic tachycardia syndrome. Methods Fifty-five children （23 male, 32 female, age 5-19 yrs, mean age 12. 3 ± 3.1 yrs） who came from Peking University First Hospital were included in the study and clinical investigations as well as standing test, basic head-up tilt test and sublingual nitroglycerin-provocated head-up tilt test under quiet circumstance were conducted. They were randomly divided into treatment group （with midodrine hydrochloride and oral rehydration salt theatment ） and control group （with oral rehydration salt treatment only）. At last, the disease-free rate, improvement rate and effective rate of symptoms, and the rate of HUT from positive to negative response were compared between control group and treatment group. SPSS 10. 0 software was used for the statistical analysis of these data. Results The symptom improvement rate in treatment group was significantly higher than that of control group after three and six weeks of treatment （ 100.0% vs. 42.4%, P 〈 0. 001 ; 100. 0% vs. 42.4%, X^2 = 19. 352, P 〈 0. 001 ）. The disease-free rate at follow-up end-point in treatment group was significantly higher than that of control group （77.3% vs. 27. 3%, X^2 = 13. 239, P 〈 0. 001 ）. The effective rate at follow-up end-point in treatment group was also significantly higher than that of control group （ 100.0% vs. 36.4% , X^2 = 22. 647, P 〈 0. 001 ）. The rate of HUT changing from positive to negative response between two groups after three weeks of treatment was not significantly different （31.8% vs. 12. 1%, P 〉 0. 05 ） , but it was significantly different （ 81.0% vs. 48.5%, P 〈 0. 05 ） after six weeks of treatment. Conclusion Selective α1 receptor agonist rnidodrine hydroehloride is effective in the treatment of children with postural orthostatic tachycardia syndrome.

关 键 词：肾上腺素能α激动剂 米多君 儿童 体位性心动过速综合征 

分 类 号：R686[医药卫生—骨科学]