磷酸肌酸钠联合孟鲁司特钠治疗小儿毛细支气管炎合并心肌损害的疗效观察

Clinical Observation on Creatine Phosphate Sodium and Montelukast Sodium in the Treatment of Children with Bronchiolitis Complicated with Myocardial Damage

目的探讨磷酸肌酸钠联合孟鲁司特钠治疗小儿毛细支气管炎合并心肌损害的临床疗效及其对患儿心肌酶谱的影响。方法选择2015年1月—2016年1月我院收治的毛细支气管炎合并心肌损害患儿86例,随机分成对照组与观察组,每组43例。两组均给予祛痰、止咳、平喘、抗感染及抗病毒等常规治疗,对照组在此基础上加用孟鲁司特钠;观察组在对照组的基础上再加用磷酸肌酸钠,两组疗程均为1周。观察并记录两组患儿的临床疗效,治疗前后心肌酶谱中磷酸肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)及α-羟基丁酸脱氢酶(HBDH)表达水平,以及不良反应情况。结果观察组治疗总有效率为93.0%,显著高于对照组的74.4%,差异有统计学意义(P<0.05);治疗后两组患儿血清CK、CK-MB、AST、LDH及HBDH水平均显著改善,且观察组的改善程度明显优于对照组,差异有统计学意义(P<0.05);同时两组患儿均无明显的不良反应。结论磷酸肌酸钠联合孟鲁司特钠治疗小儿毛细支气管炎合并心肌损害的疗效显著,可明显改善心肌酶谱水平。

Objective To investigate the clinical efficacy of creatine phosphate sodium and montelukast in the treatment of children with bronchiolitis complicated with myocardial damage and its effect of serum myocardial enzyme spectrum.Methods Eighty-six cases of children with bronchiolitis complicated with myocardial damage in our hospital from January 2015 to January 2016 were randomly divided into two groups：control group（n=43）treated with montelukast sodium,and treatment group（n=43）treated with creatine phosphate sodium and montelukast in the basis of routine treatment for 1 week.The clinical curative effect,the expression levels of myocardial enzymes,creatine kinase（CK）,creatine kinase isoenzyme（CK-MB）,aspartate aminotransferase（AST）,lactate dehydrogenase（LDH）,hydroxybutyric dehydrogenase（HBDH）before and after the treatment,and adverse reaction were observed.Results The total clinical effective rate was significantly higher in treatment group than that in control group（93.0%vs 74.4%,P〈0.05）.After treatment,the levels of serum CK,CK-MB,AST,LDH and HBDH improved in two groups,which was better in treatment group than that in control group（P〈0.05）.There was no obvious adverse reactions in two groups.Conclusion Creatine phosphate sodium and montelukast sodium has significant effect,which can significantly improve the levels of myocardial enzymes in children with bronchiolitis complicated with myocardial damage.