左卡尼汀治疗儿童心肌病的临床疗效观察

Observation on Clinical Efficacy of Levocarnitine for the Treatment of Pediatric Patients with Cardiomyopathy

【目的】探讨左卡尼汀对儿童心肌病患者心功能的影响。【方法】本院收治的88例心肌病患者随机分为试验组和对照组，对照组给予常规治疗，试验组在对照组治疗基础上缓慢静脉注射左卡尼汀100mg／（kg·d），疗程14d，后改为左卡尼汀口服，6岁以下10mL／d（1．0g／10mE），7岁以上每次10mL，1日2次。观察两组患者治疗前后心功能改善情况及心电图、血C反应蛋白（CRP）、心肌酶的变化并进行比较。【结果】治疗后试验组和对照组患者左室射血分数（LVEF）、心排出量（CO）、每搏输出量（SV）、心指数（CI）及左心舒张功能指标：EF斜率（MVEF）和左室后壁运动快充盈期分数（LFFPw）较治疗前明显提高；血CRP、心肌酶较治疗前明显下降，且差异有显著性（P〈0．05）。且试验组较对照纽改善更明显，两组相比较差异有显著性（P〈0．05）。【结论】左卡尼汀可以改善儿童心肌病患者心功能，且疗效显著。

[Objective] To explore the effect of levocarnitine on cardiac function of pediatric patients with cardiomyopathy. [Me thods]A total of 88 patients with myocardiopathy were randomly divided into treatment group and control group. The control group received conventional therapy. Based on the treatment of control group, the treatment group received intravenous injection with levocarnitine 100mg/kg. d for 14 days, and then changed to oral levocarnitine consistently. The oral dosage was 10mL（1.0g/10mL） once a day in patients un- der 6 years old and 10ml twice a day in patients older than 7 years old. The improvement of cardiac function, electrocardiography and the changes of C-reactive protein（CRP） and myocardial enzymes before and after treat- ment were observed. Electrocardiography, blood CRP and myocardial enzymes were compared. [Results] Compared with before treatment, left ventricular ejection fraction（LVEF）, cardiac output（CO）, stroke vol- ume（SV）, cardiac index（CI） and left cardiac diastolic function indexes such as EF slope（MVEF） and left ven- tricular wall motion fast filling phase fraction（LFFPW） obviously increased after treatment. Compared with before treatment, blood CRP and myocardial enzymes obviously decreased after treatment, and there were sig- nificant differences（ P 〈0.05）. The improvement of treatment group was more obvious than that of control group, and there was significant difference（ P〈0.05）. [Conclusion] Levocarnitine can improve cardiae func- tion in pediatric patients with cardiomyopathy. Levoearnitine for the treatment of pediatric patients with car- diomyopathy can achieve good efficacy. L-carnitine has a good therapeutic effect in pediatric patients with car- diomyopathy.