CAJ | 학술논문

目的比较口服补液盐、美托洛尔及盐酸米多君3种治疗方法对儿童体位性心动过速综合征(postural tachycardia syndrome,POTS)的疗效.方法对2004年12月至2013年1月确诊的POTS患儿进行电话或门诊随访,共244例,分为口服补液盐组(75例)、美托洛尔组(66例)和盐酸米多君组(103例),随访时间3 ～100个月.结果各组患儿治疗3个月后症状评分较基础症状评分均明显降低,盐酸米多君的疗效明显优于美托洛尔和口服补液盐(x2=8.750,P=0.013).244例患儿中,共有142例在3个月内进行门诊随诊并复查直立试验.各治疗组卧立位心率差值较治疗前均减小(P＜0.05).各组患儿随访结束时的症状评分较基础症状评分均明显降低(P＜0.05).Kaplan-Meier曲线比较各组患儿在随访期间的治疗效果表明,盐酸米多君的累计有效率明显高于美托洛尔和口服补液盐(89.3％vs 78.8％,P=0.033;89.3％vs 76.0％,P=0.002).结论与口服补液和美托洛尔比较,盐酸米多君治疗POTS的短期和长期疗效更好.
목적 비교구복보액염、미탁락이급염산미다군3충치료방법대인동체위성심동과속종합정(postural tachycardia syndrome,POTS)적료효.방법 대2004년12월지2013년1월학진적POTS환인진행전화혹문진수방,공244례,분위구복보액염조(75례)、미탁락이조(66례)화염산미다군조(103례),수방시간3 ～100개월.결과 각조환인치료3개월후증상평분교기출증상평분균명현강저,염산미다군적료효명현우우미탁락이화구복보액염(x2=8.750,P=0.013).244례환인중,공유142례재3개월내진행문진수진병복사직립시험.각치료조와립위심솔차치교치료전균감소(P＜0.05).각조환인수방결속시적증상평분교기출증상평분균명현강저(P＜0.05).Kaplan-Meier곡선비교각조환인재수방기간적치료효과표명,염산미다군적루계유효솔명현고우미탁락이화구복보액염(89.3％vs 78.8％,P=0.033;89.3％vs 76.0％,P=0.002).결론 여구복보액화미탁락이비교,염산미다군치료POTS적단기화장기료효경호.
Objective To compare the short-term and long-term therapeutic effects of oral rehydration salts,metoprolol or midodrine hydrochloride in children with postural tachycardia syndrome (POTS).Methods Two hundred and forty-four children with POTS diagnosed in the First Hospital Peking University of from Dec.2004 to Jan.2013 were followed up in clinics or by telephone.They were divided into oral rehydration salt group (n =75),metoprolol group (n =66) and midodrine hydrochloride group (n =103).The patients were followed up for 3 ～ 100 months.Results After 3 months of treatment,the symptom scoring of the three groups was improved greatly as compared with the baseline data.Therapeutic effect of midodrine hydrochloride group was significantly superior to metoprolol group and oral rehydration salt group (x2 =8.750,P =0.013).One hundred and forty-two out of 244 children were followed up and their head-up tilt test(HUT)was repeated.The HR increment of children in 3 groups became smaller as compared with before treatment (P ＜ 0.05).After follow-up,the symptom scoring was improved greatly as compared with the baseline scoring (P ＜ 0.05).The short-term effect of midodrine hydrochloride group was significantly better than that of metoprolol group or oral rehydration salt group (x2 =8.750,P =0.013).The Kaplan-Meier curves showed that the long-term effect of midodrine hydrochloride group was significantly superior to metoprolol group and oral rehydration salt group (89.3％vs 78.8％,P =0.033;89.3％ vs 76.0％,P =0.002).Conclusion Oral rehydration salts,midodrine hydrochloride or metoprolol were all effective for POTS in children.And the short-term and long-term effect of midodrine hydrochloride might be superior to metoprolol and oral rehydration salts.