1，6-二磷酸果糖联合抗病毒治疗对小儿病毒性心肌炎疗效的研究

Therapeutic effect of fructose-1,6-diphosphate combined antiviral treatment on pediatric patients with viral myocarditis

目的:探讨1,6-二磷酸果糖(FDP)联合抗病毒治疗对小儿病毒性心肌炎(VMC)的疗效。方法:选择118例VMC患儿,随机分为常规治疗组和联合治疗组(在常规治疗基础上接受FDP治疗),各59例,均治疗2周。测量比较两组患儿治疗后的临床疗效及治疗前后肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(HBDH)、心率(HR)、每搏输出量(SV)、心输出量(CO)、左室射血分数(LVEF)的差异。结果:联合治疗组治疗后总有效率显著高于常规治疗组(91.53%比71.19%,P=0.005)。与治疗前比较,两组治疗2周后CK、LDH、CK-MB、HBDH水平、HR均显著降低而SV、CO、LVEF均显著升高(P均<0.01)。与常规治疗组比较,治疗2周后联合治疗组CK[(168.2±33.7)U/L比(126.4±30.4)U/L]、LDH[(199.0±41.3)U/L比(162.7±47.1)U/L]、CK-MB[(18.3±6.4)U/L比(12.2±6.6)U/L]、HR[(85.4±12.6)次/分比(80.2±12.3)次/分]降低更显著而SV[(82.4±13.4)ml比(89.5±14.0)ml]、LVEF[(50.1±8.5)%比(59.7±8.8)%]升高更显著(P<0.05或<0.01)。结论:FDP联合抗病毒治疗能显著改善VMC患儿心肌酶谱,恢复心脏泵血功能,临床疗效显著。

Objective： To explore therapeutic effect of fructose-1, 6-diphosphate （FDP） combined antiviral treatment on pediatric patients with viral myocarditis （VMC）. Methods： A total of 118 VMC children were randomly and equally divided into routine treatment group and combined treatment group （received FDP therapy based on routine treatment）, both groups were treated for two weeks. Therapeutic effect after treatment, levels of creatine kinase （CK）, lactate dehydrogenase （LDH）, CK isoenzyme MB （CK-MB）, α-hydroxybutyrate dehydrogenase （HBDH）, heart rate （HR）, stroke volume （SV）, and after treatment were measured and cardiac output （CO） and left ventricular ejection fraction （LVEF） before compared between two groups. Results： Total effective rate of combined treatment group was significantly higher than that of routine treatment group （91.53% vs. 71.19%, P = 0. 005）. Compared with before treatment after two-week treatment, there were significant reductions in levels of CK, LDH, CK-MB, HBDH and HR, and significant rise in SV, CO and LVEF in two groups, P〈0.01 all. Compared with routine treatment group after two-week treatment, there were significant reductions in levels of CK [ （168.2 ± 33.7） U/Lvs. （126.4±30.4） U/L], LDH[ （199.0±41.3） U/Lvs. （162.7±47.1） U/L], CK-MB[ （18.3±6.4） U/ L vs. （12.2 ± 6. 6） U/L], and HR [ （85. 4 ± 12.6） times/rain vs. （80. 2 ± 12.3） times/mini, and significant rise in SV [ （82.4±13.4） mlvs. （89.5±14.0） ml] andLVEF [ （50.1±8.5）% vs. （59.7±8.8）%]incombinedtreat- ment group, P〈0.05 or 〈0.01. Conclusion： Fructose-I, 6-diphosphate combined antiviral therapy could signifi- cantly improve myocardial enzyme levels, recover cardiac pump function with significant therapeutic effect in VMC pediatric patients.