体位性心动过速综合征血浆硫化氢和血流介导血管舒张反应关系研究  

The relationship between plasma hydrogen sulfide and flow-mediated vasodilation in children with postural orthostatic tachycardia syndrome

作　　者：赵娟[1] 廖莹[1] 杨锦艳[1] 蔺婧[1] 刘平[1] 王瑜丽[1] 张春雨[1] 闫辉[1] 金红芳[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》2014年第9期687-690,共4页Chinese Journal of Practical Pediatrics

基　　金：国家十二五支撑计划项目(2012BAI03B03)

摘　　要：目的探讨体位性心动过速综合征(POTS)儿童血浆硫化氢(H2S)含量和血流介导血管舒张反应(FMD)的变化及二者之间的关系。方法收集自2013年1月至7月在北京大学第一医院儿科门诊或住院部经直立试验或直立倾斜试验确诊为POTS的儿童36例,(11±3)岁;以18例正常儿童为对照组,(11±4)岁。POTS的诊断依据临床表现及直立试验或直立倾斜试验,血浆H2S含量测定使用敏感硫电极方法,FMD的测定使用彩色多普勒超声检测方法。结果两组儿童在年龄、性别分布、身高、体重、体重指数、平均动脉压方面差异无统计学意义(P>0.05),POTS组儿童平卧位心率明显高于正常对照,分别为(88±15)次/min和(77±11)次/min(P=0.006)。血浆H2S含量在POTS组明显高于正常对照[(30.25±11.64)μmol/L和(17.58±1.74)μmol/L,P<0.01],FMD水平在POTS组明显高于正常对照[(9.87±1.63)%和(5.92±2.14)%,P<0.001],血浆H2S含量与FMD水平呈明显正相关,相关系数为0.565(P<0.001)。结论 POTS儿童血浆H2S含量和FMD水平明显升高,提示POTS儿童中异常的血管舒张反应。Objective This study was designed to explore the changes in hydrogen sulfide （H2S） and flow-mediated va- sodilation （FMD） in postural orthostatic tachycardia syndrome （POTS） children and the relationship between them. Methods The study included 36 POTS children aged 11±3 and 18 normal children aged 11±4 as controls. The diagnosis of POTS was based on clinical manifestation and head-up test or head-up tilt test. The plasma concentration of H2S was determined by a sensitive sulphur electrode method and FMD of brachial artery was measured using color Doppler vascular ultrasound. Results There were no significant differences between the POTS and control groups in age, sex ratio, height, weight, body mass index and mean arterial pressure （P 〉 0.05）. In POTS children, the supine heart rate （88~15 bpm） was higher than the controls （77± 11 bpm, P=0.006 ）. Plasma H2S level was significantly higher in POTS group than in the control group （30.25± 11.64 μmol/L in POTS group vs 17.58±1.74 μmol/L in control group ,P 〈 0.01 ）. The FMD in POTS group was significantly higher than in the controls （9.87± 1.63% vs 5.92±2.14%, P 〈 0.001 ） .In addition, there was a significant positive correlations between H2S and FMD （r=-0.565, P 〈 0.001 ）.Conclusion Plasma H2S and FMD are significantly increased in POTS children. The abnormal vasodilation may play an important role in POTS of children.

关 键 词：体位性心动过速综合征 硫化氢 血管舒张反应 儿童 

分 类 号：R72[医药卫生—儿科]