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目的探讨米多君对血管迷走性晕厥儿童的治疗效果。方法将2003-07—2004-12在北京大学第一医院儿科就诊的46例晕厥反复发作、直立倾斜试验(HUT)阳性的血管迷走性晕厥患儿,分为米多君组、美托洛尔组及基础治疗组。首先应用HUT评价患儿的治疗反应及调整药物,所有患儿随访6个月后,如没有晕厥的发作者则停药,并继续随访。进一步评价患儿晕厥复发情况及药物的不良反应。结果米多君组、美托洛尔组及基础治疗组3组患儿HUT转阴率分别为75·0%、65·0%及20·0%。米多君组及美托洛尔组患儿的HUT转阴率明显高于基础治疗组(P均<0·05),而给药治疗的两组患儿的HUT转阴率差异无显著性(P>0·05)。在随访过程中,米多君组及美托洛尔组晕厥复发率分别为22·2%及30·7%,而基础治疗组的晕厥复发率为80·0%,前两组晕厥复发率显著低于后组(P均<0·05)。前两组之间的复发率差异无显著性(P>0·05)。结论米多君可有效治疗血管迷走性晕厥儿童。
Objective To investigate the effect of midodrine on children with vasovagal syncope. Methods 46 children with syncope recurrent and upright tilt test (HUT) -positive vasovagal syncope in pediatric department of Peking University First Hospital from July 2003 to April 2004 were divided into midodrine group, metoprolol group Group and basic treatment group. HUT was first used to evaluate the treatment response and medication in children. All children were stopped after 6 months of follow-up, and those who did not have syncope were taken and were followed up. Further evaluation of children with recurrent syncope and adverse drug reactions. Results The HUT negative rates of Midodrine group, metoprolol group and basic treatment group were 75.0%, 65.0% and 20.0% respectively. Middletown and metoprolol group HTR rate was significantly higher than the basic treatment group (P all <0.05), while the treatment of children with HUT negative conversion rate was no significant difference (P> 0.05). During the follow-up period, the relapse rates of syncope in the midodrine and metoprolol groups were 22.2% and 30.7%, respectively, while those in the basic treatment group were 80.0%. The first two groups had a relapse rate of syncope Significantly lower than the latter group (all P <0.05). There was no significant difference in the recurrence rate between the two groups (P> 0.05). Conclusion Midodrine can effectively treat children with vasovagal syncope.