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中国循证儿科杂志

中国循证儿科杂志 ›› 2025, Vol. 20 ›› Issue (1): 41-43.DOI: 10.3969/j.issn.1673-5501.2025.01.006

• 论著 • 上一篇    下一篇

周期性呕吐综合征患儿肾素-血管紧张素-醛固酮系统指标异常的病例对照研究


宋琳,孙蕊,王健,李宁宁,杜燕燕,贺兰,徐樨巍
  

  1. 清华大学附属北京清华长庚医院儿科, 清华大学临床医学院 北京，102218
  • 收稿日期:2024-10-17 修回日期:2025-01-09 出版日期:2025-02-25 发布日期:2025-02-25
  • 通讯作者: 徐樨巍

Abnormal indicators of renin angiotensin aldosterone system in children with cyclic vomiting syndrome:A case-control study

SONG Lin, SUN Rui, WANG Jian, LI Ningning, DU Yanyan, HE Lan, XU Xiwei#br#   

  1. Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
  • Received:2024-10-17 Revised:2025-01-09 Online:2025-02-25 Published:2025-02-25
  • Contact: XU Xiwei

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摘要： 背景：周期性呕吐综合征(CVS)是一种功能性胃肠病，尚无CVS和肾素-血管紧张素-醛固酮系统（RAAS）关联的文献报告。 目的：探讨CVS患儿的RAAS指标变化特点及其影响因素。 设计：病例对照研究。 方法：：纳入2022年1月至2024年5月在清华大学附属北京清华长庚医院儿科住院的首次确诊CVS且在非发作期采血行卧位RAAS系统检查的患儿, 根据RAAS结果：分为正常组和异常组，采集发病年龄、入院年龄、性别、身高、体重, 入院血压、平均发作持续时间、平均每日呕吐频次、RAAS水平、电解质、皮质醇、ACTH, 行单因素和多因素分析。 主要结局指标：影响RAAS异常的可能因素。 结果：纳入CVS 105例, RAAS正常组49例(46.7%), RAAS异常组56例, 其中肾素浓度升高39例(69.6%)，血管紧张素Ⅱ升高28例(50.0%)，醛固酮浓度开高28例(50.0%)。两组入院年龄、发病年龄、舒张压、血钾差异均有统计学意义(P<0.05)，二元Logistic回归分析显示入院年龄是影响RAAS异常的因素, 年龄越小, 越容易发生RAAS异常。 结论：CVS患儿有53.3%出现RAAS指标异常，年龄是主要的影响因素。

关键词: 周期性呕吐综合征, 儿童, 肾素-血管紧张素-醛固酮系统

Abstract: Background：Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder. There is no literature report on the association between CVS and renin angiotensin aldosterone system (RAAS). Objective： To explore the characteristics of changes in RAAS indicators and their influencing factors in children with CVS. Design：A case-control study. Methods：Children diagnosed with CVS for the first time and undergoing supine RAAS system examination with blood sampling during non-attack period were included in the pediatric department of Beijing Tsinghua Changgung Hospital from January 2022 to May 2024. According to the RAASResults：, they were divided into normal and abnormal groups, and their age of onset, age of admission, gender, height, weight, admission blood pressure, average duration of episodes, average daily vomiting frequency, RAAS levels, electrolytes, cortisol, and ACTH were collected for univariate and multivariate analysis. Main outcome measures：Possible factors influencing the normal and abnormal outcomes of RAAS. Results：A total of 105 cases of CVS were included in this study, including 49 cases (46.7%) in the normal RAAS group and 56 cases in the abnormal RAAS group. Among them, 39 cases (69.6%) had elevated renin concentration, 28 cases (50.0%) had elevated angiotensin II concentration, and 28 cases (50.0%) had elevated aldosterone concentration. There were statistically significant differences (P<0.05) in admission age, onset age, diastolic blood pressure, and blood potassium between the two groups. Binary logistic regression analysis showed that admission age was a factor affecting RAAS abnormalities, and the younger the age, the more likely RAAS abnormalities were to occur. Conclusion：RAAS abnormalities were present in 53.3% of children with CVS, and younger age was identified as the primary influencing factor.

Key words: Cyclic vomiting syndrome, Children, Renin angiotensin aldosterone system