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 ›› 2017, Vol. 9 ›› Issue (6): 507-510.doi: 10.3969/j.issn.1674-3865.2017.06.015

• 临床研究 • 上一篇    下一篇

磷酸肌酸治疗小儿柯萨奇病毒心肌炎疗效观察

李军，王志宏，严颖煦，李波   

  1. 150010 哈尔滨，哈尔滨市儿童医院心血管内科
  • 出版日期:2017-12-25 上线日期:2018-11-19
  • 通讯作者: 李波，E-mail:18686863061@163.com
  • 作者简介:李军（1962-），女，医学硕士，主任医师。研究方向：小儿心血管系统疾病的诊治

Clinical observation on the treatment with creatine phosphate for children with coxsackie virus myocarditis

LI Jun，WANG Zhihong，YAN Yingxu，LI Bo   

  1. Cardiovascular Department,Harbin Children's Hospital，Harbin 150010，China
  • Published:2017-12-25 Online:2018-11-19

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129

摘要：
目的
观察磷酸肌酸对小儿柯萨奇病毒心肌炎（CVM）的疗效。
方法
选择2012年1月至2016年1月哈尔滨市儿童医院心血管内科收治的CVM患儿80例，随机分为观察组和对照组各40例。两组均常规给与抗病毒及对症治疗。对照组在常规治疗基础上加1，6-二磷酸果糖静脉滴注，观察组在常规治疗基础上加用磷酸肌酸静脉滴注，疗程均为2周。观察两组患儿治疗前后乳酸脱氢酶（LDH）、羟丁酸脱氢酶（HBDH）、肌酸激酶（CK）、肌酸激酶同功酶MB（CK-MB）水平变化情况；心电图，并发症如心脏扩大、心力衰竭改善情况及临床疗效。
结果
两组治疗后心肌酶学指标（LDH、HBDH、CK、CK-MB）均显著低于治疗前，差异有统计学意义（P<0.05）。观察组治疗后心肌酶学指标（LDH、HBDH、CK、CK-MB）显著低于对照组，差异有统计学意义（P<0.05）。观察组ST-T改变、期前收缩治疗总有效率与对照组比较差异有统计学意义（P<0.05）。观察组传导阻滞及并发症（心脏扩大、心力衰竭）治疗后总有效率与对照组比较差异无统计学意义（P>0.05）；观察组患儿总有效率为97.5%（39/40），显著高于对照组72.5%（29/40），差异有统计学意义（P<0.05）。
结论
磷酸肌酸治疗小儿CVM疗效显著。

关键词: 柯萨奇病毒心肌炎, 磷酸肌酸, 儿童

Abstract:
Objective
To observe the effect of creatine phosphate on pediatric coxsackie virus myocarditis（CVM).
Methods
From Jan. 2012 to Jan. 2016,80 CVM patients were treated in the Cardiovascular Department of Harbin Children's Hospital;these patients were divided into observation group and control group randomly,each with 40 cases. Both groups were routinely given antiviral treatment and symptomatic treatment. Patients in control group were treated by 1,6-diphosphate fructose(FDP) by intravenous dripping on the basis of routine therapy;patients in observation group was treated by creatine phosphate by intravenous dripping on the basis of routine therapy,both groups being treated for 2 weeks. The level of lactic dehydrogenase(LDH),hydrocybutyrate defydrogenase(HBDH),creatine kinase(CK) and creatine kinase isoenzyme(CK-MB) of both groups was observed before and after treatment;electrocardiogram,complication such as cardiac dilatation,improvement of heart failure and clinical efficacy were observed before and after therapy in both groups.
Results
LDH,HBDH,CK,CK-MB in both groups were significantly lower after treatment than before treatment(P<0.05). LDH,HBDH,CK,CK-MB in observation group were significantly lower than control group after treatment(P<0.05). ST-T changes and the total effective rates in the treatment of premature beats had significant difference between the two groups(P<0.05).Conduction block,dilatation of heart,the total effective rates in the treatment of heart failure were of no significant difference between the two groups(P>0.05). The total effective rate was 97.5%（39/40）in observation group,significantly higher than that of control group 72.5%（29/40)(P<0.05).
Conclusion
Creatine phosphate has significant effect in the treatment of pediatric CVM.

Key words: Coxsackie virus myocarditis, Creatine phosphate, Children