摘要目的:分析对阵发性室上性心动过速(supra ventricular tachycardia，SVT)患儿发作时心肌损伤标志物的变化及各种治疗方法的疗效。方法:回顾性分析2018年10月至2019年10月就诊于首都医科大学附属北京儿童医院的256例SVT患儿的临床资料。根据患儿发作年龄分0～3岁、>3～6岁、>6岁组；根据发作时不同心率分<180次/min、180～260次/min、>260次/min组；根据患儿的治疗方法分物理治疗组、药物治疗组和射频消融组。收集患儿SVT发作频次，发作时心率，发作终止后2 h内血清肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTn)I、脑利钠肽(brain natiuretic peptide，BNP)指标；统计各治疗组的转复率。结果:256例患儿中，男135例，女121例；年龄1个月～18岁，平均年龄(10.2±2.2)岁，SVT发作1～8次。SVT发作时心率越快，CK-MB、cTnI和BNP越高( P<0.05)。物理治疗组转复率27.6%，药物治疗组转复率98.0%，射频消融组根治率100%。ATP成功复律34例(47.2%)，普罗帕酮成功复律109例(71.7%)，西地兰成功复律64例(67.3%)，异搏定成功复律31例(59.6%)，索他洛尔成功复律24例(61.5%)，胺碘酮成功复律29例(54.7%)。应用2种药物转律成功82例(32.7%)；应用3种药物转律成功38例(15.1%)。 结论:SVT发作时对多数患儿有心肌损伤；心率越快，心肌的损伤就越重；儿童SVT的治疗临床上大龄儿童仍应首选物理治疗，无效则应选用药物治疗，药物治疗转复率高。射频消融是目前临床上根治快速性心律失常最有效的方法。

abstractsObjective:To analyze the changes of myocardial damage markers during ventricular tachycardia (SVT) onset and efficacy of various therapeutic approaches.Methods:The clinical data of 256 children with SVT admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from October 2018 to October 2019 were retrospectively analyzed.According to the age of onset, children were divided into groups of 0~3 years old, >3-6 years old, and >6 years old.According to the different heart rates at the time of attack, patients were divided into the groups of <180 times/min, 180~260 times /min, and >260 times /min.According to the treatment methods, children were divided into physical therapy group, drug therapy group and radiofrequency ablation group.Frequency of SVT attacks, heart rate at the onset, serum creatine kinase isoenzyme (CK-MB), troponin (cTn) I, and brain natiuretic peptide(BNP) were collected within 2 h after the onset stop.The recovery rate of each treatment group was counted.Results:Among the 256 cases, there were 135 males and 121 females, which aged from 1 month to 18 years, mean age was (10.2±2.2) years and SVT attacked from 1 to 8 times.The faster the heart rate during SVT attack, the higher CK-MB, cTnI and BNP ( P<0.05). The recovery rate was 27.6% in the mechanical stimulation group, 98.0% in the drug treatment group and 100% in the radiofrequency ablation group, respectively.Successful recovery rate was 47.2%(34 cases)with ATP, 71.7%(109 cases)with Propafenone, 67.3%(64 cases)with Cediland, 59.6%(31 cases)with Verapamil, 61.5%(24 cases)with Sotalol and 54.7%(29 cases)with Amiodarone.Eithty-two cases were successfully converted by two drugs(32.7%) and 38 cases were successfully converted by three drugs(15.1%). Conclusion:When SVT attacks, most children have myocardial damage.The faster the heart rate, the greater the damage in the heart muscle; The treatment of SVT in children should still be the first choice of physical therapy in older children, and if it is not effective, drug therapy should be selected.Radiofrequency ablation is the most effective method to cure tachyarrhythmia.