左卡尼汀治疗重症肺炎所致心力衰竭患儿的疗效评价

Curative effect of levocarnitine on heart failure caused by severe pneumonia in children

目的探讨左卡尼汀治疗重症肺炎所致心力衰竭患儿的临床效果。方法选取在我院治疗的90例重症肺炎所致心力衰竭患儿(2013年3月-2016年1月)作为研究对象,分为研究组和对照组各45例患儿,均采用强心、利尿、抗感染及支持治疗,其中45例患儿同时给予左卡尼汀治疗(研究组),对比两组的临床效果差异。结果治疗前,研究组和对照组患儿的LVEF%、24h尿量、BNP、c Tn I、CK-MB、NPY、ALD、ANF比较差异均无统计学意义(P>0.05);治疗后,研究组患儿的LVEF%值显著的高于对照组(P<0.05),研究组患儿的c Tn I、CK-MB值显著的低于对照组(P<0.05);研究组患儿的发热、肺部啰音、咳嗽、呼吸困难缓解时间、住院时间显著低于对照组,差异具有统计学意义(P<0.05);治疗后,研究组患儿显效73.33%、有效24.44%、无效2.22%,对照组患儿显效53.33%、有效40.00%、无效6.67%,差异具有统计学意义(P<0.05)。结论左卡尼汀能够显著地改善重症肺炎所致心力衰竭患儿的心功能,减轻心肌损伤,提升治疗效果。

Objective To investigate the clinical effect of levocarnitine in treatment of severe pneumonia in children with heart failure. Methods A total of 90 children with severe pneumonia caused by heart failure（ from March 2013 to January 2016） who were treated in our hospital were selected as study subjects. All of them were treated with cardiac and diuretic,anti-infection and supportive care,and 45 patients in the study group were given lcarnitine treatment. The clinical effect was compared. Results Before treatment,there was no significant difference in LVEF%,24 h urinary production,BNP,c Tn I,urine CK-MB,NPY,ALD and ANF between the two groups（ P〈0. 05）. After treatment,the value of LVEF% were significantly higher in the study group than in the control group（ P〈0. 05）,and the level of c Tn I and CK-MB was significantly lower in the study group than in the control group（ P〈0. 05）. The duration of fever,pulmonary rales,cough,dyspnea remission and hospital stay was significantly lower in the study group than in the control group（ P〈0. 05）. After treatment,the markedly effective rate was 73. 33%,the effective rate was 24. 44%,and the invalid was 2. 22% in study group,which was 53. 33%,40% and 6. 67%,respectively in the control group（ P〈0. 05）. Conclusion L-carnitine can significantly improve the heart failure caused by severe pneumonia in children with heart failure,reduce myocardial injury,and improve the treatment effect.