盐酸米多君对儿童血管迷走性晕厥的干预效果  

Efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope

作　　者：刘晓燕[1] 王成[1] 吴礼嘉[1] 胡春艳[1] 林萍[1] 李茗香[1] 崔小丽[1] 谢振武[1] 

机构地区：[1]中南大学湘雅二医院儿科心血管病研究室中南大学儿科学研究所,长沙410011

出　　处：《中华医学杂志》2009年第28期1951-1954,共4页National Medical Journal of China

基　　金：“十五”国家科技攻关计划（2004BA720A10）;湖南省科技厅科技计划（2008SK3111）

摘　　要：目的探讨盐酸米多君对儿童血管迷走性晕厥（VVS）的干预效果。方法2007年4月至2008年10月在中南大学湘雅二医院儿童晕厥专科就诊或住院的6-17（11±3）岁48例不明原因晕厥或晕厥先兆、直立倾斜试验（HUTT）阳性的VVS患儿，分健康教育组（n=10）、口服补液盐组（n=23）、盐酸米多君组（n=15）3组，根据HUTT结果评价疗效。治疗6个月后，如没有晕厥或晕厥先兆发作则停药并继续随访，评价患儿晕厥及晕厥先兆复发率、药物不良反应及干预前后血流动力学变化。数据统计用SPSS11．5软件。结果①HUTT总转阴率在健康教育组、VI服补液盐组及盐酸米多君组分别为20．0％（2／10）、60．9％（14／23）及80．0％（12／15），其中盐酸米多君组及口服补液盐组均明显高于健康教育组（均P〈0．05），盐酸米多君组及VI服补液盐组差异无统计学意义（P〉0．05）。②随访6-12个月，晕厥及晕厥先兆复发率在健康教育组、口服补液盐组、盐酸米多君组分别为60．0％（6／10）、52．2％（12／23）及13．3％（2／15），盐酸米多君组明显低于前两组（P〈0．05），健康教育组和口服补液盐组差异无统计学意义（P〉0．05）。③3组在干预前、后平卧位血压和心率差异无统计学意义（P〉0．05）；盐酸米多君组干预后心率及血压差值在倾斜起始较基础平卧位显著缩小（均P〈0．05）。结论健康教育和补液补盐是治疗VVS儿童的基本措施，盐酸米多君能增加其干预效果，且安全有效。Objective To explore the efficacy of midodrine hydrochloride in the treatment of vasovagal syncope （VVS） in children. Methods Forty-eight children with unexplained syncope and prodromata （21 males,27 females, aged 6 - 17 years, mean 11 years ± 3 years） were randomly assigned into 3 groups. They were health education group, oresol group and midodrine hydrochloride group respectively. Oresol group was comprised of children given oresol as first-line therapy in addition to health education and midodrine hydrochloride group patients given midodrine hydrochloride on the basis of oresol group. Repeated head-up tilt testing （HUTr） and follow-ups of at least 6 months were conducted to evaluate the therapeutic efficacy, side effects of midodrine hydrochloride and hemodynamic changes in treating pediatric VVS. Results ①The HUTT-based effective rate of 3 group was 20. 0% （2/10）, 60. 9% （ 14/23 ） and 80. 0% （12/15） respectively. It was significantly higher in cases of midodrine hydrochloride group and oresol group than that of health education group （P 〈 0. 05 ）. However, there was no significant difference in the HUTT- based effective rate between oresol group and midodrine hydrochloride group （ P 〉 0. 05 ）. ② During the follow-up period, the recurrence rate of syncope was significantly lower in midodrine hydrochloride group than in＇other two groups （P 〈 0. 05）. However, there was no significant difference in the recurrence rate of syncope between health education and oresol groups （ P 〉 0. 05 ）. ③ There was no statistic difference in supine hemodynamic indices （HR, SBP, DBP） between before and after treatment in 3 groups. After midodrine therapy, the effects of midodrine upon changes in systolic and diastolic pressures and heart rate,between upright beginning and supine positions, were statistically significant （ P 〈 0.05 ）. Conclusion Health education and oresol are conventional therapies for pediatric VVS. The efficacy can be enhanced by supplementing mid

关 键 词：晕厥 血管迷走神经性 儿童 米多君 治疗 

分 类 号：R686[医药卫生—骨科学]