To compare the curative effect and the changes of serum electrolytes between oral rehydration salts (ORS) I and ORS III treatment in neurally mediated syncope children. Methods: The children with the symptom of unexplained syncope and pre-syncope were collected in Second Xiangya Hospital from May 2014 to May 2017. After head-up tilt test (HUTT), their serum electrolytes levels were examined. Children who were positive in the HUTT received ORS (ORS I or ORS III) and health education. Subjects were randomly divided into an ORS I group (n=27) and an ORS III group (n=49). Results: There was no statistical significance in sex, age, height, body mass, initial diagnosis and re-diagnosis interval between the 2 groups (P>0.05); the total efficiency after ORS III and ORS I treatment were 79.59% and 62.96%, respectively, with no statistical significance (χ2=2.483, P>0.05); the HUTT negative conversion rate after ORS III and ORS I treatment were 51.02% and 48.16%, respectively, with no statistical significance (χ2=0.058, P>0.05); before treatment, the serum sodium [(140.20±2.26) mmol/L vs (138.39±2.72) mmol/L; t=2.856, P<0.05] in the ORS III group was higher than that in the ORS I group, the serum phosphorus [(1.46±0.19) mmol/L vs (1.65±0.29) mmol/L; t=3.146, P<0.05] in the ORS III group was lower than that in the ORS I group; after treatment, the serum sodium [(140.31±2.01) mmol/L vs (138.88±2.08) mmol/L; t=2.692, P<0.05] and serum calcium [(2.31±0.09) mmol/L vs (2.24±0.11) mmol/L; t=2.696, P<0.05] in the ORS III group were higher than those in the ORS I group, the serum phosphorus [(1.45±0.16) mmol/L vs (1.61±0.25) mmol/L; t=3.128, P<0.05] in the ORS III group was lower than that in the ORS I group; after ORS III treatment, there was no statistical significance in serum electrolytes between HUTT positive group and HUTT negative group (P>0.05); after ORS I treatment, the serum calcium [(2.29±0.10) mmol/L vs (2.19±0.10) mmol/L; t=2.501, P<0.05] and serum phosphorus [(1.71±0.24) mmol/L vs (1.50±0.21) mmol/L; t=2.392, P<0.05] in HUTT positive group were higher than those in HUTT negative group. There was no statistical significance in serum sodium, potassium, magnesium, and chloride (P>0.05); there was no statistical significance in serum electrolytes between pre-treatment and post-treatment in the ORS I group and the ORS III group (P>0.05); there was no statistical significance in serum electrolytes between vasovagal syncope and postural orthostatic tachycardia syndrome in the ORS I group and the ORS III group before ORS treatment (P>0.05). Conclusion: The ORS III and ORS I have the similar efficacy in the treatment of children with neurally mediated syncope. ORS III is easier to be accepted by children than ORS I, with better compliance.
目的：探讨不同的口服补液盐(oral rehydration salts，ORS)治疗儿童神经介导性晕厥(neurally mediated syncope，NMS)的疗效及血清电解质变化。方法：收集2014年5月至2017年5月因不明原因晕厥及晕厥先兆等症状在中南大学湘雅二医院儿童心血管专科门诊初次就诊或住院的患儿，直立倾斜试验(head-up tilt test，HUTT)阳性确诊为NMS，同期完善血清电解质检测，随机分为ORS I组(n=27)和ORS III组(n=49)。给予健康教育结合口服ORS(ORS I或ORS III)干预并随访。结果：两组性别、年龄、身高、体重、初诊/复诊间隔时间方面比较差异无统计学意义(P>0.05)。两组总有效率比较差异无统计学意义(79.59% vs 62.96%；χ2=2.483，P>0.05)；两组HUTT转阴率比较差异无统计学意义(51.02% vs 48.13%；χ2=0.058，P>0.05)。治疗前ORS III组较ORS I组血清钠水平[(140.20±2.26) mmol/L vs (138.39±2.72) mmol/L；t=2.856，P<0.05]增高，血清磷水平[(1.46±0.19) mmol/L vs (1.65±0.29) mmol/L；t=3.146，P<0.05]降低；治疗后ORS III组较ORS I组血清钠水平[(140.31±2.01) mmol/L vs (138.88±2.08) mmol/L；t=2.692，P<0.05]、血清钙水平[(2.31±0.09) mmol/L vs (2.24±0.11) mmol/L；t=2.696，P<0.05]增高，血清磷水平[(1.45±0.16) mmol/L vs (1.61±0.25) mmol/L；t=3.128，P<0.05]降低。ORS III组治疗后HUTT阳性组和HUTT阴性组血清电解质水平比较差异无统计学意义(P>0.05)，ORS I组治疗后HUTT阳性组较HUTT阴性组血清钙、磷水平增加(P<0.05)，血清钠、钾、氯、镁水平差异均无统计学意义(P>0.05)。ORS III和ORS I治疗前、后的血清电解质水平比较差异均无统计学意义(P>0.05)。ORS I组和ORS III组中的血管迷走性晕厥和体位性心动过速综合征患儿血清电解质水平比较差异均无统计学意义(P>0.05)。结论：ORS III与ORS I治疗儿童NMS疗效相当，但ORS III较ORS I依从性更好，患儿更易接受。.