摘要
目的探讨左卡尼汀对手足口病(HFMD)伴心肌酶异常的影响。方法收集2013年5月-2016年6月诊治的660例伴心肌酶异常的HFMD患儿,随机分为A组(果糖二磷酸钠治疗组,220例)、B组(左卡尼汀治疗组,220例)、C组(左卡尼汀联合果糖二磷酸钠治疗组,220例),3组患儿均予常规基础治疗。分别在治疗前和治疗后7 d,检测血AST、LDH、CK、CK-MB、c Tn I水平的变化,同时观察每日心率变化、治疗前后心电图变化以及重症转化率等指标,并进行统计分析。结果治疗前,3组患儿性别、年龄、病程、病情严重程度等指标比较差异无统计学意义;治疗后,B组和C组患儿痊愈率,显著高于A组(均P<0.05);B组和C组患儿重症转化率、心电图恢复率均显著低于A组(均P<0.05);心率恢复正常时间,B组和C组均较A组明显缩短(均P<0.05);而B组和C组两组比较,在临床痊愈率、重症转化率、心电图恢复率、心率恢复正常时间等方面,均差异无统计学意义(均P>0.05);治疗后心肌酶谱指标AST、LDH、CK、CK-MB、c Tn I恢复率比较,B组、C组均显著高于A组(均P<0.05);心肌酶谱指标平均水平B组和C组患儿均较A组降低(均P<0.05);而B组和C组治疗后心肌酶恢复正常率、心肌酶谱指标平均水平,均差异无统计学意义(均P>0.05)。结论肠道病毒感染后HFMD并心肌酶异常的患儿,给以左卡尼汀等辅助营养心肌治疗可显著改善心肌酶谱指标及心电图的异常,同时降低危重症转化率及改善预后。
Objective To observe the clinical effects of L-carnitine in myocardial enzyme abnormality caused by enterovirus in children with hand foot and mouth disease （HFMD）. Methods 660 HFMD children patients with myocardial enzyme abnormality from May 2013 to June 2016 were enrolled and randomly divided into three groups. Group A （n = 220） was treated with I＇6-FDP, group B with L-camitine and group C with L-carnitine combined with I＇6-FDP. All groups were given routine anti-virus and symptomatic treatment. The clinical efficacy was compared across the three groups in terms of myocardial enzyme spectrum, heart rate, ECG, severe conver- sion rate before and after treatment. Results （ 1 ） Before treatment, there was no significant difference between the three groups in gender, age, course of disease, heart rate, myocardial enzyme spectrum and other indicators. （2） After treatment, the cure rate of HFMD in group B and group C were significantly higher than that in group A （both P 〈 0.05 ） ; the rate of severe cases and the ECG normal rate in group B and group C were significantly lower than those in group A （both P 〈 0.05 ） , the time for heart rate resuming to normal in group B and in group C was all significantly shorter than that in group A （both P 〈 0.05 ）. There were no significant differences between group B and group C in clinical cure rate, severe conversion rate, recovery rate of ECG and heart rate recovery （all P 〉 0.05）. （3） In comparison with group A, after treatment, the levels of myocardial enzyme in group A and group B were decreased significantly （P 〈 0.05 ） and the recovery rates of myocardial enzyme in group A and the group B were significantly higher （P 〈 0.05） , but no significant difference were observed between group A and group B （P 〉 0.05）. Conclusions For HFMD children with myocardial enzyme abnormality caused by enterovJrus, L-car- nitine together with myocardial nutritional therapy can significantly improve the myocardial enzyme indexes and electrocardiogram abnormality. It reduces the rate of severe cases and improve the prognosis.
出处
《实用医学杂志》
CAS
北大核心
2017年第19期3290-3294,共5页
The Journal of Practical Medicine
基金
常州四药临床药学科研基金项目(编号:CZSYJJ16033)
