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目的:探讨快速饮用大量口服补液盐对儿童体位性心动过速综合征的影响及机制。方法:对21例体位性心动过速综合征患儿于两次直立倾斜试验(HUTT)前15 min分别给予250 ml和30 ml的口服补液盐,采用多功能心电监护仪记录心率和测定血压、心动过速的时间,利用动态心电图分析系统进行心率变异分析。结果:快速饮用大量口服补液盐能够明显延长出现HUTT阳性反应的时间(P=0.035);与30 ml组的直立位心率(126.65±10.63)次/min相比,250 ml组(109.86±11.57)次/min明显下降,差异有统计学意义(P<0.05);250 ml组在平卧位时LFnorm、HFnorm的值与30 ml组差异无统计学意义(P>0.05),LF/HF的值较30 ml组稍减低但差异无统计学意义(P>0.05)。250 ml组和30 ml组LF/HF在平卧位改为直立位后均表现为持续升高,但在HUTT5min时250 ml组LF/HF值较30 ml组低,差异有统计学意义(P<0.05)。结论:快速饮用大量口服补液盐能在一定程度上延长体位性心动过速综合征患儿的直立耐受时间,且不会影响动脉血压。
Objective: To investigate the effect and mechanism of rapid consumption of large quantities of oral rehydration salts on orthostatic tachycardia in children. METHODS: Twenty-one patients with orthostatic tachycardia were given oral rehydration salts of 250 ml and 30 ml respectively 15 min before the two orthostatic tilt tests (HUTT). The heart rate and blood pressure , Tachycardia time, the use of dynamic electrocardiogram analysis system analysis of heart rate variability. RESULTS: Rapid oral administration of large doses of oral rehydration salts significantly prolonged the time to HUTT positive response (P = 0.035). Compared with the echogenicity of 30 ml group (126.65 ± 10.63) / min, the 250 ml group (109.86 ± 11.57) (P <0.05). There was no significant difference between the LFnorm and HFnorm values in the 250 ml group and those in the 30 ml group (P> 0.05). The value of LF / HF Slightly lower than the 30 ml group, but the difference was not statistically significant (P> 0.05). LF / HF in 250 ml and 30 ml groups showed a continuous increase after changing from supine position to upright position, but the LF / HF value in 250 ml group was lower than that in 30 ml group at HUTT for 5min, the difference was statistically significant (P <0.05). Conclusion: Rapid consumption of large quantities of oral rehydration salts can prolong orthostatic tolerance in children with orthostatic tachycardia syndrome to a certain extent without affecting arterial blood pressure.