快速饮用口服补液盐对儿童体位性心动过速综合征的影响及机制分析

Effect of rapid drinking of oral rehydration salts on children with postural orthostatic tachycardia syndrome and the mechanism

目的:探讨快速饮用大量口服补液盐对儿童体位性心动过速综合征的影响及机制。方法:对21例体位性心动过速综合征患儿于两次直立倾斜试验(HUTT)前15 min分别给予250 ml和30 ml的口服补液盐,采用多功能心电监护仪记录心率和测定血压、心动过速的时间,利用动态心电图分析系统进行心率变异分析。结果:快速饮用大量口服补液盐能够明显延长出现HUTT阳性反应的时间(P=0.035);与30 ml组的直立位心率(126.65±10.63)次/min相比,250 ml组(109.86±11.57)次/min明显下降,差异有统计学意义(P<0.05);250 ml组在平卧位时LFnorm、HFnorm的值与30 ml组差异无统计学意义(P>0.05),LF/HF的值较30 ml组稍减低但差异无统计学意义(P>0.05)。250 ml组和30 ml组LF/HF在平卧位改为直立位后均表现为持续升高,但在HUTT5min时250 ml组LF/HF值较30 ml组低,差异有统计学意义(P<0.05)。结论:快速饮用大量口服补液盐能在一定程度上延长体位性心动过速综合征患儿的直立耐受时间,且不会影响动脉血压。

Objective： To explore the effect of rapid drinking of oral rehydration salts （ORS） on children with postural orthostatic tachycardia syndrome （POTS） and the mechanism. Methods： ORS （250 ml and 30 ml） were given at 15 minutes before head-up tilt test （HUTF） twice among 21 POTS children, multifunction electrocardiogram monitor was used to record heart rate and detect blood tachycardia, and the time of tachycardia, dynamic electrocardiogram was used to conduct heart rate variability analysis. Results： Rapid drinking of ORS significantly prolonged the time of appearance of HUTT positive reaction, there was statistically significant difference （P = 0. 035 ） . Com- pared with 30 ml group （126. 65 ± 10. 63 times per minute）, orthostatic heart rate in 250 ml group （109. 86 ± 11.57 times per minute） de- creased significantly （P〈0. 05） ; there was no statistically significant difference in LFnorm and HFnorm in the supine position between 250 ml group and 30 ml group （ P〉0. 05 ）, LF/HF ratio in 250 ml group was slightly lower than that in 30 ml group, but there was no statistically significant difference （ P〉0. 05） . When from prostration to uptight position, LF/HF ratios in 250 ml group and 30 ml group increased con- tinuously, but LF/HF ratio at 5 minutes during HUTF in 250 ml group was statistically significantly lower than that in 30 ml group （P〈 0. 05） . Conclusion： To a certain extent, rapid drinking of 250 ml ORS can prolong orthostatic tolerance in children with POTS, and it does not affect arterial blood pressure.