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目的探讨β受体阻滞剂对自主神经介导性晕厥儿童的治疗效果。方法研究对象为1995年5月至2006年4月在北京、湖南、湖北、上海4地就诊或住院的103例自主神经介导性晕厥或接近晕厥患儿,其中男43例,女60例;年龄5～19岁,平均(12.0±2.6)岁。其中血管迷走性晕厥(VVS)患儿49例,体位性心动过速综合征(POTS)患儿54例。分别将 VVS 以及 POTS 患儿随机分为治疗组(口服美托洛尔治疗)和对照组(口服补液盐治疗),观察2组儿童临床晕厥发作次数及直立倾斜试验结果,采用 SPSS 10.0软件进行统计学分析。结果 VVS 和 POTS 治疗组的治愈率分别为60.61%和68.75%,对照组分别为18.75%和0.00%。两治疗组好转率分别为15.15%和15.63%,对照组为6.25%和40.91%。治疗组 HUT 转阴率分别为60.61%和68.75%,对照组为18.75%和9.09%。两治疗组的有效率、治愈率和 HUT 转阴率均明显高于对照组(P 均<0.01)。结论β受体阻滞剂对 VVS 患儿以及 POTS 患儿的治疗有效。
Objective To investigate the therapeutic effect of β-blocker on children with autonomic-mediated syncope. Methods The subjects were 103 autonomic-mediated syncope or syncope children from May 1995 to April 2006 in Beijing, Hunan, Hubei and Shanghai, including 43 males and 60 females. Aged 5 to 19 years, mean (12.0 ± 2.6) years. Among them, 49 cases had vasovagal syncope (VVS), and 54 cases had orthostatic tachycardia (POTS). The children with VVS and POTS were randomly divided into the treatment group (oral metoprolol treatment) and the control group (oral rehydration salt treatment), the number of clinical syncope episodes and the tilt test results were observed in two groups of children, using SPSS 10.0 software for statistics Analysis. Results The cure rates of VVS and POTS were 60.61% and 68.75% respectively, while the control group were 18.75% and 0.00% respectively. The rates of improvement in the two treatment groups were 15.15% and 15.63% respectively, while those in the control group were 6.25% and 40.91%. The negative conversion rate of HUT in the treatment group was 60.61% and 68.75% respectively, while that in the control group was 18.75% and 9.09%. The two groups of treatment efficiency, cure rate and HUT negative rate were significantly higher than the control group (P all <0.01). Conclusion β-blockers are effective in the treatment of children with VVS and POTS.