儿童及青年预激综合征患者的临床及电生理特点分析

Clinical and electrophysiological characteristics in children and adolescence with Wolff-Parkinson-White syndrome

目的：评价小于30岁的预激综合征（WPW）特别是小于18岁患者的电生理特性及射频消融的效果。方法300例预激综合征患者入选，按照年龄分为三组，A组6-17岁，B组18-29岁，C组30-75岁。通过回顾医疗记录的方法分别评价三组的临床特点、电生理特性及治疗效果。结果在所有的预激综合征患者中，110例（36.67%）小于30岁。B组中男性多于女性（男：女=50：13），A组中性别差异无统计学意义（男：女=24：23）。左侧旁道在A组（25.5%，12/47）中的比例小于B组（50.8%，32/63）及C组（55.8%，106/190），差异有统计学意义（χ^2=14.3， P=0.03）。三组患者的射频消融手术成功率为A组87.2%（41/47），B组92.1%（58/63），C组94.2%（179/190），A组低于B组和C组，差异有统计学意义（χ^2=11.6，P=0.02）。结论此研究阐述了儿童及青年预激综合征患者不同的临床及电生理特性，儿童左侧旁道发病率较低，且手术成功率相对较低。

Objective To evaluate the characteristics of electrophysiologic studies （EPS） and radiofrequency ablation （RFA） performed in subjects aged less than 30 years with Wolff-Parkinson White （WPW） syndrome, particu-larly pediatric patients under 18 years of age, based on our experience. Methods Three hundred consecutive patients with WPW syndrome were recruited and divided to three groups according to age：group A （6-17 years old）, group B （18-29 years old）, group C （30-75 years old）. The clinical, electrophysiological, and therapeutic data for these pa-tients were evaluated by a retrospective medical record review. Results A total of 110 （36.67%） of these patients were〈30 years of age. There were significantly more males than females in group B （male：female, 50：13）, and there was no significant difference in gender in group A （male：female, 24：23）. Left accessory pathway was detected less frequently in group A （25.53%, 12/47） than in group B （50.79%, 32/63） and group C （55.79%, 106/190）,χ^2=14.31, P=0.03. The surgical success rate of radiofrequency ablation was 87.2%（41/47） in group A, 92.1%（58/63） in group B, and 94.2%（179/190） in group C, which was significantly lower in group A than group B and group C （χ^2=11.6, P=0.02）. Conclusion This study describes several different electrophysiological characteristics in children and ado-lescents with WPW syndrome. Children have lower incidence of left side accessory pathway, and the surgery success-ful rate of them are lower.