ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2016, Vol. 8 ›› Issue (2): 187-189.doi: 10.3969/j.issn.1674-3865.2016.02.021

• 临床研究 • 上一篇    下一篇

大剂量丙种球蛋白治疗小儿急性重症病毒性心肌炎疗效观察

尹俊，林世光   

  1. 518108 广东 深圳，深圳市宝安区石岩人民医院儿科
  • 出版日期:2016-04-25 发布日期:2018-11-19
  • 通讯作者: 林世光，E-mail：linshiguang@163.com
  • 作者简介:尹俊(1968-)，男，主治医师。研究方向：小儿心血管系统疾病的诊治

Clinical efficacy of large dose of gamma globulin in the treatment of acute severe viral myocarditis

YIN Jun，LIN Shiguang   

  1. Department of Pediatrics,People′s Hospital of Baoan District，Shenzhen 518108，China.
  • Online:2016-04-25 Published:2018-11-19

PDF (PC)

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摘要：
目的：观察大剂量丙种球蛋白对小儿急性重症病毒性心肌炎的治疗效果。
方法：2013年1月至2015年6月深圳市宝安区石岩人民医院儿科收治住院的急性重症病毒性心肌炎患儿112例，按随机数字表法分为观察组和对照组各56例。对照组采用常规治疗，观察组在对照组治疗的基础上联合大剂量丙种球蛋白治疗，静脉滴注丙种球蛋白400 mg/(kg·d)，每日1次，连续应用5 d。两组均治疗14 d。比较两组患儿治疗前后肌酸激酶同工酶MB(CK-MB)、乳酸脱氢酶(LDH)、肌酸激酶(CK)水平变化情况，心电图改善情况及临床效果。
结果：治疗后两组患儿的CK-MB、LDH及CK水平均较治疗前明显改善，差异有统计学意义(P<005)；观察组患儿治疗后CK-MB、LDH及CK水平显著低于对照组，差异有统计学意义(P<005)。观察组患儿心电图改善率为8750%(49/56)，显著优于对照组7142%(40/56)，差异有统计学意义(P<005)。观察组治疗总有效率为9464%(53/56)，显著优于对照组8214%(46/56)，差异有统计学意义(P<005)。
结论：小儿急性重症病毒性心肌炎患儿在常规治疗的基础上采用大剂量丙种球蛋白治疗，可有效改善患儿的心肌酶谱和心电图，疗效显著，值得临床大力推广并应用。

关键词: 急性重症病毒性心肌炎, 丙种球蛋白, 大剂量, 儿童

Abstract:
Objective:To observe the clinical effect of large dose of gamma globulin on children with acute viral myocarditis.
Methods:A total of 112 patients with acute severe viral myocarditis in our hospital from 2013 January to June 2015 were divided into gamma globulin group and routine group by the random number table method,56 cases in each group.The routine group was given conventional treatment,and the gamma globulin group was given large doses of IVIG in addition to the treatment for the conventional group.The course lasted for 14 days.The levels of creatine kinase isoenzyme MB(CK-MB),lactate dehydrogenase(LDH)and creatine kinase(CK)was determined before and after treatment and compared between the two groups,and ECG improvement and clinical effect were also compared.
Results:CK-MB,LDH and CK levels after treatment in the two groups were significantly improved compared with those before treatment,the difference being statistically significant(P<005).Compared with the conventional treatment group,CK-MB,LDH and CK levels of the gamma globulin group improved more significantly,the difference being statistically significant(P<005).The electrocardiogram improvement rate of the gamma globulin group was 8750%,which was significantly higher than that of conventional group(7142%),the difference being statistically significant(P<005).The effective rate of the gamma globulin group was 9464%,which was significantly higher than the control group(8214%),the difference being statistically significant(P<005).
Conclusion:On the basis of routine therapy,large dose of gamma globulin protein in the treatment of children with acute severe viral myocarditis can effectively improve myocardial enzyme spectrum and ECG,with significant effect.It is worthy of clinical popularization and application.

Key words: Acute severe viral myocarditis, Gamma globulin, Large dose, Children