CAJ | 학술논문

目的观察盐酸米多君干预前后血管迷走性晕厥(VVS)儿童血流动力学变化,探讨盐酸米多君对VVS患儿血流动力学的影响.方法 2007-04～2009-05在中南大学湘雅二医院儿童晕厥专科就诊或住院的6～17岁[平均(11.60±2.83)岁]62例不明原因晕厥(UPS)或晕厥先兆、直立倾斜试验(HUTT)阳性的VVS患儿,分为口服补液盐组(n=36)和盐酸米多君组(n=26),根据HUTT结果评价疗效并监测其血流动力学变化.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.结果盐酸米多君组HUTT转阴率与口服补液盐组比较差异无统计学意义(P>0.05);盐酸米多君组晕厥及晕厥先兆复发率低于口服补液盐组(P<0.05);两组干预前后平卧位血压和心率比较差异无统计学意义(P>0.05).盐酸米多君组干预后血压差值(△舒张压)在倾斜起始较基础平卧位显著缩小(P<0.05).结论盐酸米多君可减少VVS儿童体位改变时血流动力学变化,改善直立不耐受症状.
목적 관찰염산미다군간예전후혈관미주성훈궐(VVS)인동혈류동역학변화,탐토염산미다군대VVS환인혈류동역학적영향.방법 2007-04～2009-05재중남대학상아이의원인동훈궐전과취진혹주원적6～17세[평균(11.60±2.83)세]62례불명원인훈궐(UPS)혹훈궐선조、직립경사시험(HUTT)양성적VVS환인,분위구복보액염조(n=36)화염산미다군조(n=26),근거HUTT결과평개료효병감측기혈류동역학변화.치료6개월후,여몰유훈궐혹훈궐선조발작칙정약병계속수방.결과 염산미다군조HUTT전음솔여구복보액염조비교차이무통계학의의(P>0.05);염산미다군조훈궐급훈궐선조복발솔저우구복보액염조(P<0.05);량조간예전후평와위혈압화심솔비교차이무통계학의의(P>0.05).염산미다군조간예후혈압차치(△서장압)재경사기시교기출평와위현저축소(P<0.05).결론 염산미다군가감소VVS인동체위개변시혈류동역학변화,개선직립불내수증상.
Objective To explore the effect of midodrinehydrochloride onhaemodynamics of vasovagal syncope (VVS) in children.Methods 62 children with unexplained syncope (UPS)and prodromata [aged 6 ～ 17 years old, mean (11.60 ± 2.83) years old] were randomly assigned into 2 groups :oresol group (n = 36) and midedrinehydrochloride group (n = 26), respectively.Repeatedhead -up tilt testing (HUTT) and at least 6 -month follow -ups were conducted to evaluate the curative effect and the changes ofhaemodynamics in treating VVS children.Results (1)There was no significant difference in thehUTT-based effective rate between oresol group and midodrinehydrochloride group (P > 0.05).(2)During the follow -up period, the recurrence rate of syncope was significantly lower in midodrinehydrochloride group than in oresol group (P < 0.05).(3)There were no statistical differences inhemodynamic indexes (HR, SBP, DBP) on supine position before and after the treatment in two groups (P > 0.05).After midodrinehydrochloride therapy, the effects of midodrinehydrochloride on the changes in diastolic pressures between uptight beginning and supine positions was statistically significant (P < 0.05).Conclusion Midodrinehydrochloride can stabilizehemodynarnics with body position changes, and improve orthostatic tolerance.