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青少年起病的体位性直立性心动过速综合征的结局

Outcomes of Adolescent-Onset Postural Orthostatic Tachycardia Syndrome.

作者信息

Bhatia Roma, Kizilbash Sarah J, Ahrens Shelley P, Killian Jill M, Kimmes Stephanie A, Knoebel Erin E, Muppa Prasuna, Weaver Amy L, Fischer Philip R

机构信息

Mayo Medical School, Rochester, MN.

Mayo Medical School, Rochester, MN; Division of General Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.

出版信息

J Pediatr. 2016 Jun;173:149-53. doi: 10.1016/j.jpeds.2016.02.035. Epub 2016 Mar 12.

Abstract

OBJECTIVES

To determine the clinical course of adolescent-onset postural orthostatic tachycardia syndrome (POTS) and to assess health-related quality of life, 2-10 years after diagnosis.

STUDY DESIGN

Pediatric patients, 13-18 years of age, diagnosed with POTS at Mayo Clinic, Rochester, from 2003 to 2010 were mailed a questionnaire if they were at least 18 years of age at the time of the mailing. The primary outcome measures were norm-based, age- and sex-adjusted, 36-Item Short Form Health Survey physical composite score and mental composite score.

RESULTS

The survey was mailed to 502 patients with a response rate of 34% (n = 172). The mean duration from diagnosis to survey completion was 5.4 (SD, 1.9) years; the mean age of the respondents at the time of the survey was 21.8 (2.2) years. The responders were predominantly females (84% vs 68% of nonresponders; P < .001). Only 33 (19%) respondents reported complete resolution of symptoms, and an additional 51% reported persistent but improved symptoms, and 28 (16%) had only intermittent symptoms. The majority (71%) consider their health at least "good." The mean physical composite score was significantly lower than the population norm (mean [SD], 36.6 [15.8] vs 50; P < .001), however, the corresponding mean mental composite score was normal (50.1 [11.2]).

CONCLUSIONS

Overall, 86% of adolescents with POTS report resolved, improved, or just intermittent symptoms, when assessed via questionnaire at an average of 5 years after initial treatment. Patients with persistent symptoms have more physical than mental health concerns.

摘要

目的

确定青少年起病的体位性直立性心动过速综合征(POTS)的临床病程,并评估诊断后2至10年与健康相关的生活质量。

研究设计

2003年至2010年在罗切斯特梅奥诊所被诊断为POTS的13至18岁儿科患者,如果在邮寄问卷时年满18岁,则会收到一份问卷。主要结局指标是基于常模、年龄和性别调整后的36项简短健康调查问卷身体综合评分和心理综合评分。

结果

问卷被邮寄给502名患者,回复率为34%(n = 172)。从诊断到调查完成的平均时长为5.4(标准差,1.9)年;调查时受访者的平均年龄为21.8(2.2)岁。回复者中女性占主导(84%,未回复者为68%;P <.001)。只有33名(19%)受访者报告症状完全缓解,另有51%报告症状持续但有所改善,28名(16%)仅有间歇性症状。大多数(71%)认为自己的健康状况至少“良好”。平均身体综合评分显著低于总体常模(平均值[标准差],36.6 [15.8] 对50;P <.001),然而,相应的平均心理综合评分正常(50.1 [11.2])。

结论

总体而言,在初始治疗后平均5年通过问卷评估时,86%的青少年POTS患者报告症状缓解、改善或仅为间歇性症状。有持续症状的患者身体方面的健康问题比心理方面更多。

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