艾司洛尔在危重型手足口病中的应用价值

发布时间：2018-05-19 09:20

本文选题：艾司洛尔 + 手足口病　；参考：《中国当代儿科杂志》2017年01期

【摘要】：目的探讨艾司洛尔治疗危重型手足口病(HFMD)的临床疗效其作用机制。方法 102例危重型HFMD患儿随机分为常规治疗组和艾司洛尔组,每组51例患儿。常规治疗组按照HFMD诊疗指南予以常规治疗,艾司洛尔组在常规治疗组基础上加用艾司洛尔。两组患儿均持续监测心率(HR)、收缩压(SBP)、呼吸频率(RR)。两组患儿分别于治疗前及治疗后1 d、3 d、5 d采血检测外周血去甲肾上腺素(NE)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及单核细胞NF-κB p65含量。在治疗前和治疗5 d后采血检测血清心肌酶及氨基末端脑钠肽前体(NT-pro BNP)的水平。结果治疗前两组患儿HR、SBP、RR、NE、TNF-α、IL-6、NF-κB p65、心肌酶、NT-pro BNP水平差异均无统计学意义。与治疗前相比,治疗后2组患儿各时间点检测的以上各指标均明显降低(P0.05)。与常规治疗组相比,艾司洛尔组治疗1 d、3 d后上述各项指标改善更明显(P0.05)。治疗5 d后艾司洛尔组患儿血清心肌酶和NT-pro BNP水平较常规治疗组改善更显著(P0.05)。结论早期应用艾司洛尔能有效地稳定危重型HFMD患儿生命体征,其可能的作用机制为降低血清儿茶酚胺浓度,减轻心肌损伤,改善心功能,减轻炎性反应。
[Abstract]:Objective to explore the effect mechanism of Ai Si lol on the treatment of critical hand foot and mouth disease (HFMD). Methods 102 children with severe severe HFMD were randomly divided into routine treatment group and Ai Si lol group, 51 children in each group. The routine treatment group was given routine treatment according to the guide of HFMD diagnosis and treatment, and the Ai Si lol group was added with Ai Si Luo on the basis of the routine treatment group. Heart rate (HR), systolic pressure (SBP) and respiratory frequency (RR) were continuously monitored in the two groups of children. The two groups were measured before and after treatment, 1 D, 3 D, 5 d for peripheral blood norepinephrine (NE), tumor necrosis factor alpha (TNF- alpha), interleukins -6 (IL-6) and mononuclear cell NF- kappa B. The level of NT-pro BNP in muscle enzyme and amino terminal brain natriuretic peptide (NT-pro BNP). Results there was no significant difference in the levels of HR, SBP, RR, NE, TNF- a, IL-6, NF- kappa B p65, myocardial enzymes and NT-pro before treatment. Compared with the treatment before treatment, the above indexes were significantly reduced in the 2 groups after treatment. The improvement of the above indexes was more obvious after 1 D and 3 D in the esmolol group (P0.05). The serum myocardial enzymes and NT-pro BNP levels in the children of esmolol group were better than those of the conventional treatment group (P0.05). Conclusion early application of esmolol can effectively stabilize the vital signs of severe severe HFMD patients, and the possible mechanism is to reduce blood. The concentration of catecholamine alleviates myocardial injury, improves cardiac function and reduces inflammatory reaction.
【作者单位】：徐州市儿童医院重症监护室;

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