儿童体位性心动过速综合征血清中一氧化氮浓度变化的探讨

Concentration of Serum Nitric Oxide in Postural Orthostatic Tachycardia Syndrome

目的探讨儿童体位性心动过速综合征(POTS)血清中一氧化氮浓度的变化。方法选择POTS患者60例,其中男22例,女38例,男∶女约为1∶1.7。选取年龄、性别相匹配的健康对照组60例,观察其各种临床表现的发生频率及辅助检查结果。取其静脉血测定血清NO和NOS浓度。结果诊断为POTS的患儿60例,在直立试验或直立倾斜(HUT)试验过程中,POTS患儿最常见的异常表现为在直立或倾斜后10min内,心率增加≥35次/min,或患儿心率测最大值≥120次/min。出现异常表现的时间平均为7±2min,21例直立6min出现异常症状,16例在直立后即可出现异常症状,23例作HUT约10min内出现异常症状。POTS组与对照组比较,NO浓度和eNOS活性均显著下降。结论POTS组与对照组比较,NO浓度和NOS活性显著下降,提示NO和eNOS在POTS发病机制中有重要作用。

Objective The aim of this article is to analyze the concentration of serum nitric oxide of POTS in children.Methods All 60 pediatric patients of POTS, 22 males and 38 females with a ratio of male to female 1：1.7 met the diagnostic criteria and were investigated. Another 60 age- and sex-matched healthy children were as controls. The serum of subjects were collected and centrifuged to measure the NO and NOS level. Results 60 patients were diagnosed as POTS. During the head-up or head-up tilt test, POTS cases had the heart rates increased ≥ 30 per min,or the max heart rates≥ 120 per min within 10 min.The average time of the occurrence of abnormal responses was about （7±2）min. There was abnormal symptom in 21 patients within 6 minutes, 16 patients in 10 immediately after standing up, and 23 patients within 10 minutes after HUT, respectively. The serum levels of NO and eNOS activity in POTS group were significantly decreased than those in control group. Conclusion The levels of NO and eNOS in POTS group were significantly decreased than those in control group, which suggests that NO and eNOS play important roles in POTS.