Tao Chunyan, Cui Yaxi, Zhang Chunyu, Liu Xueqin, Zhang Qingyou, Liu Ping, Wang Yuli, Du Junbao, Jin Hongfang
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China.
Children (Basel). 2022 Jul 17;9(7):1065. doi: 10.3390/children9071065.
(1) Background: This case-control study was designed to assess the efficacy of empiric treatment for vasovagal syncope in children; (2) Methods: We retrospectively enrolled 181 children with vasovagal syncope from the Department of Pediatrics of Peking University First Hospital. The participants were categorized into four groups, based on the empiric treatment received: conventional treatment, including health education and orthostatic training; conventional treatment plus oral rehydration salts; conventional treatment plus metoprolol; conventional treatment plus midodrine hydrochloride. Patients were followed up to evaluate the syncopal or presyncopal recurrence. Kaplan-Meier curves were drawn to explore the syncopal or presyncopal recurrence in children, and the differences were compared among the groups using a log-rank test; (3) Results: Among the 181 children with vasovagal syncope, 11 were lost to follow-up. The median time of follow-up was 20 (8, 42) months. The Kaplan-Meier survival curve showed no significant difference in syncopal or presyncopal recurrence in children treated with different empiric options according to a log-rank test ( = 1.328, = 0.723); (4) Conclusions: The efficacy of unselected empiric therapy of vasovagal syncope in children was limited, and the individualized therapies merit further studies.
(1) 背景:本病例对照研究旨在评估儿童血管迷走性晕厥经验性治疗的疗效;(2) 方法:我们回顾性纳入了北京大学第一医院儿科的181例血管迷走性晕厥患儿。根据接受的经验性治疗,将参与者分为四组:常规治疗,包括健康教育和直立训练;常规治疗加口服补液盐;常规治疗加美托洛尔;常规治疗加盐酸米多君。对患者进行随访以评估晕厥或晕厥前复发情况。绘制Kaplan-Meier曲线以探讨儿童晕厥或晕厥前复发情况,并使用对数秩检验比较各组之间的差异;(3) 结果:在181例血管迷走性晕厥患儿中,11例失访。随访时间中位数为20(8,42)个月。根据对数秩检验,Kaplan-Meier生存曲线显示不同经验性治疗方案治疗的儿童在晕厥或晕厥前复发方面无显著差异(= 1.328,= 0.723);(4) 结论:儿童血管迷走性晕厥未选择的经验性治疗疗效有限,个体化治疗值得进一步研究。