Clinical Intervention Study Based On The 24-hour Urine Sodium Levels In Children With Vasovagal Syncope

Objective: To explore the changes of urinary sodium and hemodynamics parameters in children with vasovagal syncope(VVS)based on 24-hour urine sodium levels.Methods: The study group included 120 patients with syncope and prodromal symptoms of syncope(syncope group)in the second hospital of lanzhou university June 2014 to May 2016.Select children urine sodium is less than 124 as the research object,and then divided into pure water group(n=15),oral rehydration salts group(n=21),metoprolol group(n=21),metoprolol and oral rehydration salts combined treatment group(n=22).To compare the results of HUTT after 3months of intervention,evaluate the curative effect of different schemes,analyze the changes of serum and 24-hour urinary sodium,and hemodynamics parameters.The data were analyzed by SPSS 19.0 statistical software.Result:(1)Oral rehydration salts group and combination group after treatment for 24-hour urinary sodium level significantly increased compared with before treatment,the increase of urinary sodium in the combination group was higher than that in the oral rehydration group.However,serum sodium levels did not change significantly before and after treatment(P>0.05).After treatment with the combination group and metoprolol group,the difference between the vertical tilt and the baseline heart rate was smaller than that before treatment(P<0.05).(2)The effective rates of warm water group,oral rehydration group,metoprolol group and combination therapy group were 26.67%(4/15 cases),66.67%(14/21 cases),71.43%(15/21),95.45%(21/22cases).HUTT negative rates were 6.67%(1/15),43.86%(9/21),52.38%(11/21)and 86.36%(19/22).The effective rate and HUTT negative rate in the combination group were significantly higher than those in the other three groups,the difference was statistically significant(P<0.05).(3)There was no significant difference in the serum sodium and 24-hour urinary sodium of VVS between vasodepressive type,cardioinhibitory type and mixed type(P>0.05).There were no statistically significant differences in the efficacy of the three groups(P>0.05).Conclusions: Children with lower urinary sodium has obvious changes in hemodynamicparameters.The effect of metoprolol combined with oral rehydration salts is superior to that of single drug therapy,which is a safe and effective method for the treatment of VVS.Oral rehydration salts and metoprolol combined with the treatment of three types of the same effect.