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[新生儿室上性心动过速及其与胃食管反流病的关联]

[Supraventricular tachycardia in newborns and its association with gastroesophageal reflux disease].

作者信息

Fuertes Ángeles, Alshweki Ayham, Pérez-Muñuzuri Alejandro, Couce María-Luz

机构信息

Servicio de Neonatología, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España.

Servicio de Neonatología, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España.

出版信息

An Pediatr (Barc). 2017 Oct;87(4):206-210. doi: 10.1016/j.anpedi.2016.10.006. Epub 2016 Dec 19.

DOI:10.1016/j.anpedi.2016.10.006
PMID:28007577
Abstract

INTRODUCTION

Supraventricular tachycardia (SVT) is the most common arrhythmia in the neonatal period, but its association with other triggering processes is not well established. The aim of the study was to analyse the possible relationship between neonatal SVT and gastroesophageal reflux disease (GERD), a condition which was recently linked to atrial arrhythmias.

MATERIAL AND METHODS

A retrospective longitudinal descriptive study was conducted over a period of 5years on newborns who were diagnosed with SVT in a level III neonatal unit, assessing morphological aspects, associated symptoms, and treatments received. Its association with GERD and the impact of this on SVT was studied.

RESULTS

Eighteen patients (1.2 per 1000 newborns) were diagnosed with SVT. Fifty percent of them were combined with clinically significant GERD (P=.01), and all of them received drug treatment. The average time of control of SVT without GERD since diagnosis was 6 days (95% CI: 2.16-9.84, with a median of 3) and 7.6 days when both pathologies were present (95% CI: 4.14-10.9, with a median of 7) (P=.024).

CONCLUSIONS

Patients with SVT in the neonatal period frequently have GERD, and this combination leads to more difficulty in controlling the tachycardia. The reflux could act as a trigger or perpetuator of arrhythmia, therefore it is important to find and treat GERD in infants with SVT.

摘要

引言

室上性心动过速(SVT)是新生儿期最常见的心律失常,但其与其他触发因素之间的关联尚未明确。本研究旨在分析新生儿SVT与胃食管反流病(GERD)之间可能存在的关系,胃食管反流病最近被认为与房性心律失常有关。

材料与方法

对一家三级新生儿重症监护病房5年内诊断为SVT的新生儿进行回顾性纵向描述性研究,评估其形态学特征、相关症状及接受的治疗。研究其与GERD的关联以及GERD对SVT的影响。

结果

18例患者(每1000例新生儿中有1.2例)被诊断为SVT。其中50%合并有临床意义的GERD(P = 0.01),所有患者均接受了药物治疗。无GERD的SVT患者自诊断后平均控制时间为6天(95%CI:2.16 - 9.84,中位数为3天),两种疾病并存时为7.6天(95%CI:4.14 - 10.9,中位数为7天)(P = 0.024)。

结论

新生儿期SVT患者常合并GERD,这种合并情况会导致心动过速的控制更加困难。反流可能是心律失常的触发因素或持续因素,因此对于患有SVT的婴儿,发现并治疗GERD很重要。

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