重症手足口病患儿艾司洛尔治疗前后心肌酶相关指标的变化及意义

The changes and significance of LDH,CK,CK-MB,NE in children with severe hand foot and mouth disease before and after in treatment with esmolol

[摘要]目的观察重症手足口病患几经过艾司洛尔治疗前后乳酸脱氢酶（LDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK—MB）、去甲肾上腺素（NE）等心肌酶相关指标的变化。方法选择2014年1～12月到该院进行重症手足口病治疗的急性期患儿共计136例，分为普通治疗组与艾司洛尔组，选择同期该院进行健康体检的0．5～5．0岁健康婴幼儿68例作为对照组。普通治疗组给予患儿常规的抗病毒、降低颅内压、保护心肌细胞等对症治疗。艾司洛尔组患儿在普通治疗组的治疗方案基础上给予史司洛尔治疗。所有患儿采集入院当天及治疗3d后采集静脉血，检查患儿的心肌酶各项指标。采集对照组儿童静脉血作上述指标检测。观察患儿与健康儿童的上述指标差异，观察普通治疗组与艾司洛尔组治疗前后上述指标差异。结果与同年龄段的健康儿童相比，患儿的LDH、CK、CK—MB、NE等指标明显偏高，差异有统计学意义（P〈0．05）。经过3d的治疗，普通治疗组和艾司洛尔组患儿的心肌酶指标较入院时均有显著下降，与入院时相比差异有统计学意义（P〈0．05），与普通治疗组相比艾司洛尔组指标下降的更为明显，且差异有统计学意义（P〈0．05）。结论在重症手足口病患儿的临床治疗方案中使用艾司洛尔能够缓解患儿的心肌损伤，对患儿病情向好方向的转归起到了积极作用。

Objective To explore the changes and significance of LDH,CK,CK-MB,NE in children with severe hand foot and mouth disease before and after in treatment with esmolol. Methods A total of 136 cases of children with severe hand foot and mouth disease in acute stage from January to December 2014 were selected, and randomly divided into general treatment group and esmolol group,68 cases of 0.5 to 5.0 years old children from the same period in our hospital for health examination were choosen as the control group. The general treatment group were treated with conventional antiviral therapy, reducing intracranial pressure, pro- tecting cardiac muscle cells and so on. Based on the scheme of general treatment group, esmolol group were treated with esmolol. All patients were collected blood samples on the day of admission and 3 d after treatment, the indexes of myocardial enzymes in children were examined. In the control group, the blood of children was detected as the index. The differences of the above indexes before and after treatment between the two groups were observed. Results Compared with the healthy children of the same age group, the LDH,CK,CK-MB,NE and other indicators of the children patients were significantly higher, and the difference was statistically significant （P〈0.05）. After 3 d of treatment, the general treatment group and esmolol group with myocardial enzyme index de- creased significantly when compared with those on admission, the difference had statistical significance （P〈 0.05）, compared with admission,esmolol group index droped more obvious, the difference had statistical significance（P〈0. 05）. Conclusion Clinical treatment in children with severe severe hand, foot and mouth disease using esmolol can alleviate myocardial injury in children, has played an active role in the prognosis of the patient＇s condition.