Li Lintian, Zhao Huacai, Ma Xiuxiu, Jiao Fuyong, Lin Jing
School of Public Health, Xi'an Jiaotong University, Xi'an, China.
Department of Surgical, The Third Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China.
Front Neurosci. 2022 Oct 4;16:1026539. doi: 10.3389/fnins.2022.1026539. eCollection 2022.
The vasoconstriction agent midodrine hydrochloride is a vital treatment for pediatric patients diagnosed with vasovagal syncope (VVS), although the efficacy is variable. This study was designed to explore the value of calcitonin gene-related peptide (CGRP) in predicting the effect of midodrine hydrochloride treatment upon VVS patients. In total, 55 children diagnosed with VVS were treated with midodrine hydrochloride for 3 months. Therapeutic response was evaluated using a symptom score system. CGRP levels were significantly higher in VVS patients (68.700 ± 6.460) than in control subjects (43.400 ± 5.810; = 18.207, < 0.001) and symptom scores correlated positively with CGRP concentrations ( = 0.779, < 0.001). Patients treated with midodrine hydrochloride showed a significant reduction in symptom scores [4 (0, 6.5) vs. 1 (1, 2); = -6.481; < 0.001]. However, the value of plasma CGRP were potently elevated in the positive-response subjects than in the negative-response subjects (70.080 ± 5.040) vs. (61.150 ± 3.090); = 5.817; < 0.001). The area under the ROC curve showed that the value of CGRP for predicting the therapeutic response to midodrine hydrochloride was 0.946 (95% CI: 0.879-0.997, < 0.001). With high sensitivity (97.7%) and specificity (83.3%), CGRP predicted the therapeutic response to midodrine hydrochloride (cut-off value, 62.56 pg/ml). In conclusion, CGRP can be used to predict the effect of midodrine hydrochloride administration in VVS patients.
血管收缩剂盐酸米多君是诊断为血管迷走性晕厥（VVS）的儿科患者的重要治疗方法，尽管疗效存在差异。本研究旨在探讨降钙素基因相关肽（CGRP）在预测盐酸米多君治疗VVS患者效果方面的价值。共有55例诊断为VVS的儿童接受了3个月的盐酸米多君治疗。使用症状评分系统评估治疗反应。VVS患者的CGRP水平（68.700±6.460）显著高于对照组（43.400±5.810；t = 18.207，P < 0.001），且症状评分与CGRP浓度呈正相关（r = 0.779，P < 0.001）。接受盐酸米多君治疗的患者症状评分显著降低[4（0，6.5）对1（1，2）；Z = -6.481；P < 0.001]。然而，阳性反应患者的血浆CGRP值明显高于阴性反应患者（70.080±5.040）对（61.150±3.090）；Z = 5.817；P < 0.001）。ROC曲线下面积显示，CGRP预测盐酸米多君治疗反应的价值为0.946（95%CI：0.879 - 0.997，P < 0.001）。CGRP以高敏感性（97.7%）和特异性（83.3%）预测盐酸米多君的治疗反应（截断值，62.56 pg/ml）。总之，CGRP可用于预测盐酸米多君给药对VVS患者的效果。
