CAJ | 학술논문

目的：探讨1’6-二磷酸果糖(1’6-FDP)联合左卡尼汀治疗小儿病毒性心肌炎(VMC)的临床疗效及对患者心电图和心肌酶谱的影响。方法选取2011年7月至2012年7月江山市贺村中心卫生院心内科和江山市妇幼保健院小儿科收治的126例确诊为小儿VMC的患儿为研究对象,并按照就诊顺序将其随机分为对照A组、对照B组和治疗组3组,每组各42例。对照A组单纯采用1’6-FDP治疗,对照B组单纯采用左卡尼汀治疗,治疗组则采用1’6-FDP联合左卡尼汀进行治疗,观察3患儿心电图和血清心肌酶谱变化,比较临床疗效。结果治疗组总有效率90.48%,显著高于对照A组的69.05%和对照B组的73.81%(χ2值分别为9.681,8.896,均P<0.05)。治疗组心电图恢复正常率为85.71%,明显高于对照A组和对照B组,差异均具有统计学意义(χ2值分别为8.762,8.133,均P<0.05)；3组治疗后心肌酶谱肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和乳酸脱氢酶(LDH)均较治疗前明显改善(对照A组治疗前后相比较,t值分别为6.986、7.576、18.774；对照B组治疗前后相比较,t值分别为11.217、10.465、18.597；治疗组治疗前后相比较,t值分别为6.435、7.311、14.337；均P<0.05)；而治疗组治疗后心肌酶谱CK、CK-MB和LDH均较对照A组和对照B组降低,差异均具有统计学意义(与治疗A组比较,t值分别为11.297、7.982、8.091；与治疗B组比较,t值分别为10.874、8.233、7.890；均P<0.05)。结论1’6-FDP糖联合左卡尼汀治疗小儿VMC具有显著的临床疗效,能明显改善患儿心电图和心肌酶谱。
목적：탐토1’6-이린산과당(1’6-FDP)연합좌잡니정치료소인병독성심기염(VMC)적림상료효급대환자심전도화심기매보적영향。방법선취2011년7월지2012년7월강산시하촌중심위생원심내과화강산시부유보건원소인과수치적126례학진위소인VMC적환인위연구대상,병안조취진순서장기수궤분위대조A조、대조B조화치료조3조,매조각42례。대조A조단순채용1’6-FDP치료,대조B조단순채용좌잡니정치료,치료조칙채용1’6-FDP연합좌잡니정진행치료,관찰3환인심전도화혈청심기매보변화,비교림상료효。결과치료조총유효솔90.48%,현저고우대조A조적69.05%화대조B조적73.81%(χ2치분별위9.681,8.896,균P<0.05)。치료조심전도회복정상솔위85.71%,명현고우대조A조화대조B조,차이균구유통계학의의(χ2치분별위8.762,8.133,균P<0.05)；3조치료후심기매보기산격매(CK)、기산격매동공매(CK-MB)화유산탈경매(LDH)균교치료전명현개선(대조A조치료전후상비교,t치분별위6.986、7.576、18.774；대조B조치료전후상비교,t치분별위11.217、10.465、18.597；치료조치료전후상비교,t치분별위6.435、7.311、14.337；균P<0.05)；이치료조치료후심기매보CK、CK-MB화LDH균교대조A조화대조B조강저,차이균구유통계학의의(여치료A조비교,t치분별위11.297、7.982、8.091；여치료B조비교,t치분별위10.874、8.233、7.890；균P<0.05)。결론1’6-FDP당연합좌잡니정치료소인VMC구유현저적림상료효,능명현개선환인심전도화심기매보。
Objective To investigate the clinical efficacy of 1 ’ 6 fructose diphosphate ( 1 ’ 6-FDP ) combined with Levocarnitine on treatment of viral myocarditis ( VMC) in children and its influence on ECG and myocardial enzyme spectrum of patients. Methods From July 2011 to July 2012 126 children of VMC were collected from He Village Center Hospital of Jiangshan City and Maternal and Child Health Hospital of Jiangshan City, and they were randomly divided into three groups according to visiting sequence with 42 cases in each group. Control group A was only given 1’6-FDP treatment, control group B was only given Levocarnitine, and treatment group C was given 1’6-FDP combined with Levocarnitine treatment. ECG and myocardial enzyme spectrum of three groups were observed to compare clinical efficacy. Results The total effective rate of group C was 90. 48%, which was significantly higher than 69. 05% of group A and 73. 81% of group B (χ2 value was 9. 681 and 8. 896, respectively, both P<0. 05). The rate of ECG returning to normal of group C was 85. 71%, which was significantly higher than group A and group B, and the difference was significant (χ2 value was 8. 762 and 8. 133, respectively, both P<0. 05). The myocardial enzymes CK, CK-MB and LDH of three groups were significantly improved after treatment (tA value was 6. 986, 7. 576 and 18. 774, respectively; tB value was 11. 217, 10. 465 and 18. 597, respectively; tC value was 6. 435, 7. 311 and 14. 337, respectively, all P <0. 05). Those of group C after treatment were significantly lower than group A and group B, and the differences were significant (tA value was 11. 297, 7. 982 and 8. 091, respectively, tB value was 10. 874, 8. 233 and 7. 890, respectively, all P <0. 05). Conclusion Combining 1’ 6-FDP with Levocarnitine has significant clinical efficacy on VMC in children, and it can significantly improve ECG and myocardial enzyme spectrum in children.