磷酸肌酸钠治疗小儿原发性心肌炎的临床疗效分析

The clinical analysis of the efficacy of creatine phosphate sodium therapy in children with primary myocarditis

目的 分析原发性心肌炎（PMC）的特点,探讨磷酸肌酸钠治疗小儿PMC的临床疗效.方法 回顾性分析56例PMC患儿的临床资料,按随机数字表法分为对照组和治疗组,每组28例,两组患儿均接受常规治疗,治疗组在此基础上加用磷酸肌酸钠,两组均连续治疗14d,观察两组的临床疗效、心肌酶谱（肌酸激酶、肌酸激酶同工酶MB、乳酸脱氢酶）、肌钙蛋白及心电图改善情况.结果 治疗后,治疗组总有效率明显高于对照组[89.3％ （25/28）比53.6％（15/28）],差异有统计学意义（x2=4.094,P＜ 0.05）.两组患儿经治疗后,心肌酶谱均较治疗前明显改善,差异有统计学意义（P＜0.05）;且治疗组改善程度优于对照组,差异有统计学意义（P＜0.05）.治疗组治疗后肌钙蛋白转阴率明显高于对照组（16/18比9/17）,差异有统计学意义（x2=6.052,P＜ 0.05）.治疗组心电图改善的总有效率明显高于对照组[96.4％（27/28）比67.9％（19/28）],差异有统计学意义（x2=3.896,P＜0.05）.结论 磷酸肌酸钠用于治疗小儿PMC,临床疗效较好,心肌酶谱、肌钙蛋白等生理指标明显改善,具有一定的临床推广意义.

Objective To analyze the characteristics of primary myocarditis,and investigate the clinical efficacy of creatine phosphate sodium therapy in children with primary myocarditis.Methods A retrospective analysis of 56 cases of primary myocarditis in children,divided into control group and treatment group by random digits table method,each group 28 cases.Two groups of patients received conventional treatment,the treatment group was added the use of creatine phosphate sodium,after 14 d of continuous treatment,the clinical efficacy,myocardial enzymes （creatine kinase,creatine kinase-MB,lactate dehydrogenase）,troponin and ECG in both groups were observed.Results After treatment,the total effective rate in treatment group was significantly higher than that in control group [89.3%（25/28） vs.53.6% （15/28）] （x2 =4.094,P 〈0.05）.The myocardial enzymes after treatment in both groups significantly improved compared with before treatment （P 〈 0.05）,the improvement in treatment group was better than that in control group,the difference was statistically significant （P 〈 0.05）.The negative conversion ratio of troponin in treatment group was significantly higher than that in control group （16/18 vs.9/17）（x2 =6.052,P 〈 0.05）.The total effective rate of ECG in treatment group was significantly higher than that in control group （x2 =3.896,P 〈 0.05）.Conclusions Creatine phosphate sodium for the treatment of children with primary myocarditis has better clinical efficacy,physiological indicators of myocardial enzymes,such as troponin significantly improve,with some clinical significance.