β受体阻滞剂和α受体激动剂治疗儿童体位性心动过速综合征Meta分析  

A meta-analysis of α-adrenoceptor agonists and β-blockers for the treatment of postural orthostatic tachycardia syndrome in children

作　　者：邓文军[1] 杜军保[1] 

机构地区：[1]北京大学第一医院儿科,北京100034

出　　处：《中国实用儿科杂志》2013年第5期357-360,共4页Chinese Journal of Practical Pediatrics

基　　金：国家十二五科技支撑计划(2012BA103B03);首都特色研究项目(D10100050010059)

摘　　要：目的评价β受体阻滞剂和α受体激动剂对儿童体位性心动过速综合征(POTS)的治疗效果。方法 2011年北京大学第一医院儿科根据纳入及排除标准于PubMed数据库(1990—2011年)、EMBASE数据库(1990—2011年)、ELEVIER数据库(1990—2011年)、CNKI数据库(1990—2011年)收集筛选临床对照研究文献。采用Juni量表评价纳入文献质量,采用ReviewManager4.2软件进行Meta分析。结果美托洛尔(OR=4.21,95%CI:2.24～7.91,P<0.01)、盐酸米多君(OR=7.71,95%CI:3.37～17.62,P<0.01)均能明显改善POTS儿童的临床症状,且后者效果好于前者[(80.9±10.7)%vs.(92.5±3.9)%,t=-10.687,P<0.01]。结论美托洛尔和盐酸米多君均能改善POTS患者临床症状,且盐酸米多君优于美托洛尔。Objective To evaluate the efficacy of treating postural orthostatic tachycardia syndrome （POTS） in children with metoprolol and midodrine hydrochloride.Methods According to inclusion and exclusion criteria, clinical trails were selected from the databases PubMed （ 1990-2011 ）, EMBASE （ 1990-2011 ）, ELEVIER （ 1990-2011 ） and CNKI （1990--2011 ）. The studies were then assessed based on the Juni assessment, and metal-analysis was completed using the Review Manager 4.2 software.Results Totally 7 clinical trails were selected. Funnel plot analysis showed possible publication bias. Meta-analysis of the seven studies showed that metoprolol （OR = 4.21,95%CI ： 2.24 ± 7.91, P 〈 0.01 ） and midodrine hydrochloride （OR = 7.71,95%CI： 3.37 ± 17.62, P 〈 0.01 ） were more effective than placebos in treating POTS. Furthermore , weighted independent t-test revealed that the weighted mean percentage of responders for mido- drine hydrochloride was higher than that for metoprolol（92.5% ±3.9% vs. 80.9% ± 10.7%, t = -10.687, P 〈 0.01 ）.Con- clusion Metoprolol and midodrine hydrochloride are effective in treating POTS. Metoprolol can be more effective than midodrine hydrochloride.

关 键 词：心动过速综合征 META分析 美托洛尔 盐酸米多君 

分 类 号：R72[医药卫生—儿科]