左卡尼汀对柯萨奇A16型病毒感染手足口病的心肌保护作用

发布时间：2018-04-16 12:28

本文选题：手足口病 + 左卡尼汀　；参考：《中国当代儿科杂志》2017年08期

【摘要】：目的探讨左卡尼汀对柯萨奇病毒A16型感染所致手足口病(HFMD)的心肌保护作用及机制。方法 60例心肌酶谱异常的HFMD患儿随机分为左卡尼汀治疗组(左卡组)和1,6-二磷酸果糖治疗组(果糖组),每组30例,在抗病毒、退热等基础上分别给予左卡尼汀或果糖二磷酸钠治疗,并以同期体检的健康儿童30例为对照组。比较HFMD患儿治疗前后的心肌酶谱、丙二醛(MDA)、超氧化物岐化酶(SOD)、细胞凋亡因子sFas和sFasL的变化。结果两组HFMD患儿治疗有效性的差异无统计学意义(P0.05),仅果糖组1例进展为危重型。治疗前,左卡组和果糖组心肌酶谱、MDA、sFas、sFasL水平高于对照组(P0.05),SOD低于对照组(P0.05),但HFMD的两组间心肌酶谱、MDA、SOD、sFas、sFasL的差异无统计学意义(P0.05)。治疗后,左卡组和果糖组的心肌酶谱以及MDA、sFas、sFasL浓度均下降(P0.05),SOD水平增高(P0.05);治疗后除果糖组的CK高于对照组和左卡组,其余心肌酶指标及MDA、sFas、sFasl在两组间及与对照组的差异均无统计学意义(P0.05)。SOD水平与AST、LDH、CK、CK-MB呈负相关(r分别为-0.437、-0.364、-0.397、-0.519,P0.05),MDA水平与LDH、CK-MB呈正相关(r分别为0.382、0.411,P0.05)。结论左卡尼汀对柯萨奇病毒A16型感染所致HFMD有较好的心肌保护作用,可能与清除氧自由基和抑制心肌细胞凋亡有关。
[Abstract]:Objective to investigate the myocardial protective effect and mechanism of levacarnitine on HFMD caused by Coxsackie virus A 16 infection.Methods Sixty children with HFMD with abnormal myocardial enzyme spectrum were randomly divided into two groups: L-carnitine treatment group (left carnitine group) and fructose 1-carnitine diphosphate group (fructose group, 30 cases in each group).Leucarnitine or fructose diphosphate were given on the basis of antipyretic therapy and 30 healthy children were taken as control group.The changes of myocardial enzymes, malondialdehyde (MDA), superoxide dismutase (SOD), apoptosis factor (sFas) and sFasL in children with HFMD were compared before and after treatment.Results there was no significant difference between the two groups in the efficacy of HFMD treatment, only one case in fructose group developed critical type.Before treatment, the level of MDAS FassFasL in left carb group and fructose group was higher than that in control group (P 0.05), but there was no significant difference in myocardial enzyme spectrum between HFMD group and control group (P 0.05).After treatment, the myocardial enzyme spectrum and the concentration of MDA-FassFasL in the left calorie group and fructose group were decreased, and the level of SOD in the fructose-free group was higher than that in the control group and the left calorie group, and the level of SOD in the fructose-free group was higher than that in the control group and the left calorie group after treatment.There was no significant difference between the other myocardial enzymes and MDA-FassFasl between the two groups and between the control group and the two groups. There was a negative correlation between the level of SOD and the level of CK-MB in ASTN LDHN CKCK-MB. The positive correlation between the level of MDA and the level of LDHK-MB were -0.437- 0.364n- 0.397- 0.397- 0.519P0.05MDA and 0.382 卤0.411P0.05respectively.Conclusion L-carnitine has a better myocardial protective effect on HFMD induced by Coxsackie virus A16 infection, which may be related to scavenging oxygen free radicals and inhibiting cardiomyocyte apoptosis.
【作者单位】：郑州市儿童医院;郑州市儿童急危重症医学重点实验室;
【基金】：常州四药临床药学科研基金项目(CZSYJJ16033)
【分类号】：R725.1

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