儿童体位性心动过速综合征治疗随访的单中心研究  

signal centefollow -up study on the treatmenof postural tachycardisyndrome in children

作　　者：蔺婧[1] 刘平[1] 王瑜丽[1] 金红芳[1] 杨锦艳[1] 赵娟[1] 冯雪丽[1] 张春雨[1] 廖莹[1] 闫辉[1] 陈永红[1] 刘雪芹[1] 杜军保[1] 

机构地区：[1]北京大学第一医院儿科,100034

出　　处：《中华实用儿科临床杂志》2015年第13期983-987,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：“十二五”国家科技支撑计划（2012BA103803）

摘　　要：目的比较盐酸米多君＋口服补液盐、美托洛尔＋口服补液盐及单纯口服补液盐3种治疗方法对儿童体位性心动过速综合征（POTS）的疗效。方法POTS患儿共192例，分为盐酸米多君＋口服补液盐组（84例）、美托洛尔＋口服补液盐组（54例）及口服补液盐组（54例）。患儿治疗3个月后门诊随访，进行治疗后症状评分并复查直立试验，以判断其短期疗效，并了解药物不良反应；对所有接受治疗的患儿进行电话随访，判断患儿停止治疗后POTS症状的发生情况，应用Kaplan—Meier曲线比较各组患儿长期随访累计治疗效果，以判断药物治疗的长期疗效，随访时间3—122（42．7±24．3）个月。结果短期疗效：治疗后所有患儿症状评分均有降低（t=21．536，P〈0．001），在门诊随访中的直立试验结果表明，患儿的卧立位心率差值较治疗前均有降低。盐酸米多君＋口服补液盐组和美托洛尔＋口服补液盐组治疗有效率明显高于单纯口服补液盐组（x2=10．905，P=0．004），但是盐酸米多君＋口服补液盐组和美托洛尔＋口服补液盐组治疗有效率比较差异无统计学意义（x2=0．042，P=0．837）。长期疗效：应用Kaplan—Meier曲线比较各组患儿长期随访累积治疗效果，结果显示盐酸米多君＋口服补液盐长期累积有效率最高（x2=13．299，P〈0．01），美托洛尔＋口服补液盐组和单纯口服补液盐组长期累积有效率比较差异无统计学意义（x2=0．150，P=0．699）。结论短期疗效表明，盐酸米多君＋口服补液盐组和美托洛尔＋口服补液盐组治疗有效率明显高于单纯口服补液盐组；长期疗效表明，与美托洛尔＋口服补液盐、单纯口服补液盐相比，盐酸米多君＋口服补液盐治疗POTS的疗效更佳。Objective To compare the therapeutieffecof Midodrine hydrochloride pluoral rehydration sahs, Metoprolol pluoral rehydration saltand simple oral rehydration salton children with postural tachycardisyndrome （POTS）. MethodOne hundred and ninety - two children with POTwere divided into Midodrine hydrochloride pluoral rehydration saltgroup （84 cases） , Metoprolol pluoral rehydration saltgroup （54 cases） and oral rehy- dration saltgroup （54 cases）. The patientwere followed up athe outpatiendepartmenafte3 -monthtreatment. Shor-term effecwaanalyzed by reevaluating the symptom score,repeating uprightesand studying the side effectof the drugs. All the children were followed - up by telephone, mainly investigating on the syndrome recurrence and symptom - free survival by Kaplan - Meieanalysis. The follow - up time wa3 to 122 （42.7 ± 24.3 ） months. ResulShor- term effecshowed thathe symptom scorewere decreased aftetreatmen（ = 21. 536, P 〈 0.001 ）. Head - up tesshowed thadelthearrate wadecreased. The effective ratein the Midodrine hydrochloride pluoral rehydra- tion saltgroup and the Metoprolol pluoral rehydration saltgroup were significantly highethan those of the simple oral rehydration saltgroup （X2 = 10. 905, P = 0. 004 ）. Buno statistical difference wafound between the Midodrine hydrochloride pluoral rehydration saltgroup and the Metoprolol pluoral rehydration saltgroup （X2 = 0. 042, P = 0. 837 ）. Long - term effecby Kaplan - Meiecurve showed thathe therapeutieffecof Midodrine hydrochloride pluoral rehydration saltgroup wasignificantly highethan any of the othetwo group（X2 = 13.299 ,P 〈 0.01 ） ,buno statistical difference wafound between the Metoprolol pluoral rehydration saltgroup and the simple oral rehydration saltgroup （X2 = 0. 150,P = 0.699）. ConclusionIn termof the shor- term result, the effective ratein the Mido- drine hydrochloride pluoral rehydration saltgroup and the Metoprolol pluoral rehydration saltgroup were signifi- cantly highethan those of the simple oral rehy

关 键 词：心动过速 治疗 儿童 

分 类 号：R725.4[医药卫生—儿科]