1'6-FDP与左卡尼汀治疗小儿病毒性心肌炎的疗效

Therapeutic efficacy of 1'6-FDP with Levocarnitine on treatment of children with viral myocarditis

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%(x^2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(x^2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。

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.