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血细胞计数指标可预测体位性心动过速综合征患儿口服补液的疗效。

Hemocytometric Measures Predict the Efficacy of Oral Rehydration for Children with Postural Tachycardia Syndrome.

作者信息

Lu Wenxin, Yan Hui, Wu Shu, Xu Wenrui, Jin Hongfang, Du Junbao

机构信息

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

出版信息

J Pediatr. 2017 Aug;187:220-224. doi: 10.1016/j.jpeds.2017.04.034. Epub 2017 May 16.

Abstract

OBJECTIVE

To explore whether hemocytometric measures could be qualified predictors for the effect of oral rehydration salts (ORS) in children with postural tachycardia syndrome (POTS).

STUDY DESIGN

Thirty-five children with POTS and 29 healthy children were enrolled. General information, hemodynamic status, and baseline hemocytometric variables were collected. Children with POTS received ORS therapy and were followed up for 3 months. The independent risk factors of developing POTS were explored. A receiver-operating characteristic curve was used to evaluate predictive value of hemocytometric variables for therapeutic effectiveness of ORS therapy.

RESULTS

Children with POTS had larger mean corpuscular volume (MCV) and lower mean corpuscular hemoglobin concentration (MCHC) values than controls (P < .05). The baseline MCV values positively correlated with heart rate elevation from supine to upright (r = 0.294, P < .05). Both larger MCV and lower MCHC values were independent risk factors of developing POTS (for MCV, P < .05, OR 1.222; for MCHC, P < .05, OR 0.936). In children with POTS, responders to ORS had baseline lower MCV and higher MCHC than nonresponders (P < .05). The receiver-operating characteristic curve for the predictive value of MCHC showed that area under the curve was 0.73.

CONCLUSIONS

MCHC values could be used to predict the effectiveness of ORS for treating POTS in children.

摘要

目的

探讨血细胞计数指标是否可作为预测口服补液盐(ORS)对体位性心动过速综合征(POTS)患儿疗效的有效指标。

研究设计

纳入35例POTS患儿和29例健康儿童。收集一般信息、血流动力学状态和基线血细胞计数变量。POTS患儿接受ORS治疗并随访3个月。探讨发生POTS的独立危险因素。采用受试者工作特征曲线评估血细胞计数变量对ORS治疗效果的预测价值。

结果

POTS患儿的平均红细胞体积(MCV)较对照组大,平均红细胞血红蛋白浓度(MCHC)较对照组低(P < 0.05)。基线MCV值与仰卧位到直立位时心率升高呈正相关(r = 0.294,P < 0.05)。MCV增大和MCHC降低均为发生POTS的独立危险因素(MCV,P < 0.05,OR 1.222;MCHC,P < 0.05,OR 0.936)。在POTS患儿中,ORS治疗有反应者的基线MCV较无反应者低,MCHC较无反应者高(P < 0.05)。MCHC预测价值的受试者工作特征曲线显示曲线下面积为0.73。

结论

MCHC值可用于预测ORS治疗儿童POTS的疗效。

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