左卡尼汀对手足口病心肌酶谱异常的影响

发布时间：2019-01-23 17:08

【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P0.05);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P0.05);心率恢复正常时间,B组和C组均较A组明显缩短(均P0.05);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P0.05);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P0.05);心肌酶谱指标平均水平B组和C组患儿均较A组降低(均P0.05);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P0.05)。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。
[Abstract]:Objective to investigate the effect of levacarnitine on myocardial enzyme abnormalities in patients with hand, foot and mouth disease (HFMD). Methods from May 2013 to June 2016, 660 HFMD patients with abnormal myocardial enzymes were randomly divided into two groups: group A (treated with fructose diphosphate) and group), B (220 cases treated with leucarnitine). Group C (group C, 220 cases) were treated with L-carnitine and sodium fructose diphosphate. All the children in group C were treated with routine basic therapy. Blood AST,LDH,CK,CK-MB,c Tn I levels were measured before and 7 days after treatment. Daily heart rate changes, electrocardiogram changes and severe transformation rate were observed and analyzed statistically. Results before treatment, there was no significant difference in sex, age, course of disease and severity of illness among the three groups, the recovery rate of group B and group C was significantly higher than that of group A (P0.05). The severe conversion rate and ECG recovery rate of group B and group C were significantly lower than those of group A (P0.05), the time of heart rate returning to normal was significantly shorter in group B and group C than that in group A (P0.05). There was no significant difference between group B and group C in clinical recovery rate, severe conversion rate, ECG recovery rate, heart rate recovery time and so on (P0.05). The recovery rate of myocardial enzyme index AST,LDH,CK,CK-MB,c Tn I in group B and group C was significantly higher than that in group A (P0.05), and the average level of myocardial enzymes in group B and group C was lower than that in group A (P0.05). However, there was no significant difference between group B and group C in the recovery rate of myocardial enzymes and the average level of myocardial enzymes after treatment (P0.05). Conclusion in children with HFMD complicated with abnormal myocardial enzymes after enterovirus infection, the myocardial enzymes and electrocardiogram (ECG) abnormalities can be significantly improved by the treatment of L-carnitine and other supplementary nutritional myocardial treatments, and the transformation rate of critical cases is reduced and the prognosis is improved.
【作者单位】：郑州儿童医院重症监护室;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(编号:CZSYJJ16033)
【分类号】：R725.1

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