CAJ | 학술논문

目的：探讨米力农联合艾司洛尔对危重型手足口病（ HFMD）患儿心功能和心肌酶的影响。方法选取2013年3月—2014年6月徐州市儿童医院重症医学科收治入院的94例危重型手足口病患儿，随机分为对照组和观察组各47例。对照组给予米力农治疗，观察组给予米力农联合艾司洛尔治疗。于治疗前、治疗24 h后检测心输出量（ CO）、左心室射血分数（ LVEF ）、肌酸激酶（ CK ）、肌酸激酶同工酶（ CK-MB ）、血清氮末端脑钠肽前体（ NT-proBNP）、去甲肾上腺素（ NE ）并进行比较。结果治疗前，两组患儿各观察指标（ CO、LVEF、CK、CK-MB、NT-proBNP、NE）间差异均无统计学意义（P>0.05）；治疗24 h后，两组患儿各观察指标间差异均有统计学意义（P<0.05）。对照组患儿治疗后，除 NE 外，其余各观察指标与治疗前比较，差异均有统计学意义（ P <0.05）；观察组患儿治疗后与治疗前比较，各观察指标间差异均有统计学意义（ P<0.05）。对照组中，显效19例，有效17例，无效11例；观察组中，显效27例，有效16例，无效4例，两组比较差异有统计学意义（ P<0.05）。结论米力农联合艾司洛尔能有效改善危重型手足口病患儿的心功能和心肌酶水平，减轻其心肌损害。
목적：탐토미력농연합애사락이대위중형수족구병（ HFMD）환인심공능화심기매적영향。방법선취2013년3월—2014년6월서주시인동의원중증의학과수치입원적94례위중형수족구병환인，수궤분위대조조화관찰조각47례。대조조급여미력농치료，관찰조급여미력농연합애사락이치료。우치료전、치료24 h후검측심수출량（ CO）、좌심실사혈분수（ LVEF ）、기산격매（ CK ）、기산격매동공매（ CK-MB ）、혈청담말단뇌납태전체（ NT-proBNP）、거갑신상선소（ NE ）병진행비교。결과치료전，량조환인각관찰지표（ CO、LVEF、CK、CK-MB、NT-proBNP、NE）간차이균무통계학의의（P>0.05）；치료24 h후，량조환인각관찰지표간차이균유통계학의의（P<0.05）。대조조환인치료후，제 NE 외，기여각관찰지표여치료전비교，차이균유통계학의의（ P <0.05）；관찰조환인치료후여치료전비교，각관찰지표간차이균유통계학의의（ P<0.05）。대조조중，현효19례，유효17례，무효11례；관찰조중，현효27례，유효16례，무효4례，량조비교차이유통계학의의（ P<0.05）。결론미력농연합애사락이능유효개선위중형수족구병환인적심공능화심기매수평，감경기심기손해。
Objective To investigate the influence of milrinone combined with esmolol on cardiac function and myocardial enzymes in children with severe hand-foot-mouth disease(HFDM). Methods We included 94 cases of children with severe hand-foot-mouth disease who were hospitalized in the ICU of Xuzhou Children's Hospital from March,2013 to June,2014 and randomly divided them into two groups:control group(n=47)and observation group(n=47). The control group was administrated with intravenous milrinone,and the observation group was administrated with milrinone combined with esmolol. Cardiac output(CO),left ventricular ejection fraction(LVEF),creatine kinase(CK),phosphate kinase isozyme ( CK-MB),serum N-terminal proBNP( NT-proBNP)and norepinephrine( NE)were examined and compared between the two groups at admission and 24 hours after treatment. Results The two groups showed no significant difference ( P>0. 05 )in each indicator before treatment, while significant difference ( P < 0. 05 ) was observed in each indicator 24 hours after treatment. In the control group,apart from NE,significant difference(P <0. 05)was noted between all the rest indicators before treatment and those after treatment. In the observation group,significant difference(P <0. 05)was found between all indicators before treatment and those after treatment. In the control group,19 subjects had marked efficacy,17 had efficacy and 11 had no efficacy. In the observation group,27 subjects had marked efficacy,16 had efficacy and 4 had no efficacy. The differences between the two groups in efficacy were significantly different( P <0. 05 ) . Conclusion Milrinone combined with esmolol can significantly improve the cardiac function and myocardial enzyme level of children with severe hand -foot -mouth disease.