中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
13期
983-987
,共5页
蔺婧%刘平%王瑜丽%金红芳%杨锦艳%赵娟%冯雪丽%张春雨%廖莹%闫辉%陈永红刘雪芹%杜军保%Du Junbao
藺婧%劉平%王瑜麗%金紅芳%楊錦豔%趙娟%馮雪麗%張春雨%廖瑩%閆輝%陳永紅劉雪芹%杜軍保%Du Junbao
린청%류평%왕유려%금홍방%양금염%조연%풍설려%장춘우%료형%염휘%진영홍류설근%두군보%Du Junbao
心动过速%治疗%儿童
心動過速%治療%兒童
심동과속%치료%인동
Tachycardia%Therapy%Child
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（χ2＝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（χ2＝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（χ2＝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（χ2＝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。
目的：比較鹽痠米多君＋口服補液鹽、美託洛爾＋口服補液鹽及單純口服補液鹽3種治療方法對兒童體位性心動過速綜閤徵（POTS）的療效。方法 POTS 患兒共192例，分為鹽痠米多君＋口服補液鹽組（84例）、美託洛爾＋口服補液鹽組（54例）及口服補液鹽組（54例）。患兒治療3箇月後門診隨訪，進行治療後癥狀評分併複查直立試驗，以判斷其短期療效，併瞭解藥物不良反應；對所有接受治療的患兒進行電話隨訪，判斷患兒停止治療後 POTS 癥狀的髮生情況，應用 Kaplan-Meier 麯線比較各組患兒長期隨訪纍計治療效果，以判斷藥物治療的長期療效，隨訪時間3~122（42.7±24.3）箇月。結果短期療效：治療後所有患兒癥狀評分均有降低（t ＝21.536，P ﹤0.001），在門診隨訪中的直立試驗結果錶明，患兒的臥立位心率差值較治療前均有降低。鹽痠米多君＋口服補液鹽組和美託洛爾＋口服補液鹽組治療有效率明顯高于單純口服補液鹽組（χ2＝10.905，P ＝0.004），但是鹽痠米多君＋口服補液鹽組和美託洛爾＋口服補液鹽組治療有效率比較差異無統計學意義（χ2＝0.042，P ＝0.837）。長期療效：應用 Kaplan-Meier 麯線比較各組患兒長期隨訪纍積治療效果，結果顯示鹽痠米多君＋口服補液鹽長期纍積有效率最高（χ2＝13.299，P ﹤0.01），美託洛爾＋口服補液鹽組和單純口服補液鹽組長期纍積有效率比較差異無統計學意義（χ2＝0.150，P ＝0.699）。結論短期療效錶明，鹽痠米多君＋口服補液鹽組和美託洛爾＋口服補液鹽組治療有效率明顯高于單純口服補液鹽組；長期療效錶明，與美託洛爾＋口服補液鹽、單純口服補液鹽相比，鹽痠米多君＋口服補液鹽治療 POTS 的療效更佳。
목적：비교염산미다군＋구복보액염、미탁락이＋구복보액염급단순구복보액염3충치료방법대인동체위성심동과속종합정（POTS）적료효。방법 POTS 환인공192례，분위염산미다군＋구복보액염조（84례）、미탁락이＋구복보액염조（54례）급구복보액염조（54례）。환인치료3개월후문진수방，진행치료후증상평분병복사직립시험，이판단기단기료효，병료해약물불량반응；대소유접수치료적환인진행전화수방，판단환인정지치료후 POTS 증상적발생정황，응용 Kaplan-Meier 곡선비교각조환인장기수방루계치료효과，이판단약물치료적장기료효，수방시간3~122（42.7±24.3）개월。결과단기료효：치료후소유환인증상평분균유강저（t ＝21.536，P ﹤0.001），재문진수방중적직립시험결과표명，환인적와립위심솔차치교치료전균유강저。염산미다군＋구복보액염조화미탁락이＋구복보액염조치료유효솔명현고우단순구복보액염조（χ2＝10.905，P ＝0.004），단시염산미다군＋구복보액염조화미탁락이＋구복보액염조치료유효솔비교차이무통계학의의（χ2＝0.042，P ＝0.837）。장기료효：응용 Kaplan-Meier 곡선비교각조환인장기수방루적치료효과，결과현시염산미다군＋구복보액염장기루적유효솔최고（χ2＝13.299，P ﹤0.01），미탁락이＋구복보액염조화단순구복보액염조장기루적유효솔비교차이무통계학의의（χ2＝0.150，P ＝0.699）。결론단기료효표명，염산미다군＋구복보액염조화미탁락이＋구복보액염조치료유효솔명현고우단순구복보액염조；장기료효표명，여미탁락이＋구복보액염、단순구복보액염상비，염산미다군＋구복보액염치료 POTS 적료효경가。
Objective To compare the therapeutic effect of Midodrine hydrochloride plus oral rehydration salts,Metoprolol plus oral rehydration salts and simple oral rehydration salts on children with postural tachycardia syn-drome(POTS). Methods One hundred and ninety - two children with POTS were divided into Midodrine hydrochlo-ride plus oral rehydration salts group(84 cases),Metoprolol plus oral rehydration salts group(54 cases)and oral rehy-dration salts group(54 cases). The patients were followed up at the outpatient department after 3 - months treatment. Short - term effect was analyzed by reevaluating the symptom scores,repeating upright test and studying the side effects of the drugs. All the children were followed - up by telephone,mainly investigating on the syndrome recurrence and symptom - free survival by Kaplan - Meier analysis. The follow - up time was 3 to 122(42. 7 ± 24. 3)months. Results Short - term effect showed that the symptom scores were decreased after treatment(t = 21. 536,P ﹤ 0. 001). Head -up test showed that delta heart rate was decreased. The effective rates in the Midodrine hydrochloride plus oral rehydra-tion salts group and the Metoprolol plus oral rehydration salts group were significantly higher than those of the simple oral rehydration salts group(χ2 = 10. 905,P = 0. 004). But no statistical difference was found between the Midodrine hydrochloride plus oral rehydration salts group and the Metoprolol plus oral rehydration salts group(χ2 = 0. 042,P =0. 837). Long - term effect by Kaplan - Meier curve showed that the therapeutic effect of Midodrine hydrochloride plus oral rehydration salts group was significantly higher than any of the other two groups(χ2 = 13. 299,P ﹤ 0. 01),but no statistical difference was found between the Metoprolol plus oral rehydration salts group and the simple oral rehydration salts group(χ2 = 0. 150,P = 0. 699). Conclusions In terms of the short - term result,the effective rates in the Mido-drine hydrochloride plus oral rehydration salts group and the Metoprolol plus oral rehydration salts group were signifi-cantly higher than those of the simple oral rehydration salts group. The therapeutic effect of the Midodrine hydrochloride plus oral rehydration salts was superior to that of the Metoprolol plus oral rehydration salts and the simple oral rehydra-tion salts for POTS children by the long - term follow - up study.
