复合辅酶对婴儿肝炎综合征肝功能、心功能影响临床研究

Study on curative effect of coenzyme complex treating children with infantile hepatitis syndrome suffered from hepatic,cardiac funtion damage

目的研究用复合辅酶治疗婴儿肝炎综合征时患儿肝功能、心功能的变化及临床效果。方法 105例IHS患儿随机分为治疗组55例(男28例,女27例;平均年龄2.35个月)与对照组50例(男26例,女24例;平均年龄2.05个月)。二组病例均予保肝及基础治疗。治疗组在此基础上,加用注射用复合辅酶针(100u/次,1次/d),连续应用14 d为1个疗程,部分用2、3疗程。监测二组患儿治疗前后血清中总胆红素(TB)、结合胆红素(DB)、ALT、γ-谷氨酰转肽酶(γ-GT)、总胆汁酸(TBA)水平、肝脏大小及CK、CKMB、LDH、HBDH、心电图变化。采用SPSS 11.0软件进行统计学分析。结果采用注射用复合辅酶治疗2周后,治疗组患儿血清中TB(88.5±11.9μmol/L)、DB(41.7±13.5μmol/L)、ALT(72.3±6.5U/L)、γ-GT(315±126IU/L)、TBA(69.3±15.6μmol/L)、CK(75.2±16.5U/L)、CKMB(12.6±2.7U/L)、LDH(154.7±23.8U/L)、HBDH(301.5±16.8U/L)与对照组比较均有明显下降,有显著性差异(P<0.01),肝脏明显缩小(P<0.01),心电图明显恢复正常;二组均未见明显药物不良反应。结论复合辅酶能降低血清胆红素及内源性胆汁酸水平,可促进胆红素、TBA排泄,具有明显的利胆、退黄作用,同时可保护心肌,促进心肌细胞功能恢复。

Objective To explore the curative effect of coenzyme complex for injection on infantile hepatitis syndrome （IHS）. Methods One hundred and five IHS children were randomly divided into treatment group （ n = 55,28 boys and 27 girls, whose average age was 2. 35 months, receiving the basic therapies such as liver protection therapy, and so on, and coenzyme complex for injection therapy with 100u/d, 14 days as a course of treatment, and someone for 2 - 3 cour- ses of treatment） and control group（ n = 50,26 boys and 24 girls, whose averageage was 2. 05months, only receiving the basic therapies as mentioned above）. Total bilirubin （ TB ）, direct bilirubin （ DB ）, alanine am inotransferase （ ALT）,γ- glutamyltranspeptidase（ γ-GT）,total bile acid （TBA） of the serum, and the plasma concentration of creatine kinase, creatine kinase - MB ,liver size,ECG were detected before and after the treatment. SPSS 11.0 software was used to ana- lyze the data. Results Compared with control group, the levels of TB （88.5 ± 11.9μmol/L）, DB （41.7 ± 13.5μmol/L） ,ALT（72. 3 ± 6. 5U/L） γ- GT（315 ± 126IU/L） ,TBA（69.3 ± 15.6p, mol/L） in serum of treatment group reduced significantly （ P 〈 O. 01 ）, and the liver size （ 2. 7 ± 1.03 cm） reduced obviously （ P 〈 0. 01 ） ; The levels of CK（75.2 ± 16. 5U/L）, CKMB （ 12. 6 ± 2. 7U/L）, LDH （ 154.7 ± 23.8U/L）, HBDH （ 301.5 e 16. 8U/L） in serum of treatment group reduced significantly（ P 〈 0. O1 ）. The side effect of the 2 groups was not obvious. Conclusion Coen- zyme complex for injection can reduce the levels of serum bilirubin and endogenous bile acid, and promote the excretion of bilirubin and bile acid with cholagogie effect and jaundice elmi ination, and also can protect heart.