口服补液盐治疗神经介导性晕厥患儿血清和尿液中电解质的变化

The changes of electrolytes in serum and urine in children with neurally mediated syncope cured by oral rehydration salts.

作者信息

Zhang Wenhua, Zou Runmei, Wu Lijia, Luo Xuemei, Xu Yi, Li Fang, Lin Ping, Xie Zhenwu, Wang Cheng

机构信息

Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University/Institute of Pediatrics, Central South University, Changsha, Hunan 410011, China; Department of Pediatrics, The Third Hospital of Changsha, Changsha, Hunan 410015, China.

出版信息

Int J Cardiol. 2017 Apr 15;233:125-129. doi: 10.1016/j.ijcard.2016.12.138. Epub 2016 Dec 28.

DOI:10.1016/j.ijcard.2016.12.138

PMID:28043672

Abstract

OBJECTIVE

To detect the changes of electrolytes in serum and urine in children with nerve mediated syncope (NMS) cured by oral rehydration salts (ORS).

METHOD

From May 2014 to April 2015, 135 patients with symptoms like unexplained syncope and presyncope were administrated in our hospital, including 60 boys and 75 girls, aged between 4 and 16 (10.2±2.7) years. After head-up tilt test (HUTT), their electrolytes in serum and urine were examined. Those who were positive to the HUTT received ORS and health education, while others were only treated by health education. With the period of subsequent visit arranging 21-154 (42.6±27.7) days, the improvement of their clinical manifestation were inquired and electrolytes in serum and urine were re-tested.

RESULT

(1) The total effective percentage of ORS treatment was 63.0%, and the negative conversion rate of HUTT was 48.2%. (2) In the first time of visit to hospital, there was no statistical significance between the HUTT-positive and the HUTT- negative in serum electrolytes, 24-h urine electrolytes and 24-h urine volume (P>0.05). (3) In the return visit to hospital, the serum calcium and serum phosphorus in the HUTT-positive were higher than those in the HUTT-negative (P<0.05). (4) With the intake of ORS, 24-h urine sodium, 24-h urine chlorine and 24-h urine volume were improved than pre-treatment (P<0.05 or 0.01).

CONCLUSION

ORS was an effective treatment to the NMS children, with 24-h urine volume and urine chloride increasing.

摘要

目的

检测口服补液盐（ORS）治疗神经介导性晕厥（NMS）患儿血清及尿液中电解质的变化。

方法

选取2014年5月至2015年4月在我院就诊的135例有不明原因晕厥及晕厥前驱症状的患者，其中男60例，女75例，年龄4～16（10.2±2.7）岁。行直立倾斜试验（HUTT）后检测血清及尿液电解质。HUTT阳性者给予ORS及健康教育，阴性者仅给予健康教育。后续随访时间为21～154（42.6±27.7）天，询问临床表现改善情况并复测血清及尿液电解质。

结果

（1）ORS治疗总有效率为63.0%，HUTT转阴率为48.2%。（2）首次就诊时，HUTT阳性与阴性者血清电解质、24小时尿电解质及24小时尿量比较，差异无统计学意义（P>0.05）。（3）复诊时，HUTT阳性者血清钙和血清磷高于阴性者（P<0.05）。（4）服用ORS后，24小时尿钠、24小时尿氯及24小时尿量较治疗前改善（P<0.05或0.01）。