磷酸肌酸钠治疗儿童病毒性心肌炎疗效观察

Effect of creatine phosphate sodium in treatment of viral myocarditis in infants

目的 探讨磷酸肌酸钠治疗儿童病毒性心肌炎的临床效果和安全性。方法 将2017年5月至2018年8月中国人民解放军联勤保障部队第988医院收治的200例病毒性心肌炎患儿分为观察组和对照组,每组100例。2组患儿均给予吸氧、抗氧自由基、抗病毒、抗心律失常、维持水电解质和酸碱平衡等综合治疗;在此基础上,对照组患儿给予1,6-二磷酸果糖100~250mg·kg^-1,静脉滴注,每日1次;辅酶Q100.4g,口服,每日2次;疗程2周;观察组患儿给予磷酸肌酸钠0.5~1.0g,30~45min内静脉滴注完毕,每日1次,疗程2周。分别于治疗前后检测2组患儿血清磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)及心肌肌钙蛋白T(cTnT)水平,治疗后比较2组患儿的治疗效果及不良反应。结果 治疗前2组患儿血清CK、CK-MB、LDH及cTnT水平比较差异无统计学意义(P>0.05),2组患儿治疗后血清CK、CK-MB、LDH及cTnT水平均低于治疗前(P<0.05);治疗后,观察组患儿血清CK、CK-MB、LDH及cTnT水平显著低于对照组(P<0.05)。观察组和对照组患儿治疗总有效率分别为98.00%(98/100)、90.00%(90/100),观察组患儿治疗总有效率高于对照组(χ^2=4.343,P<0.05)。2组患儿均未发生严重不良反应。结论 磷酸肌酸钠治疗儿童病毒性心肌炎的临床效果确切,且安全性高。

Objective To explore the therapeutic effect of creatine phosphate sodium in treatment of viral myocarditis in infants.Methods Two hundred children with viral myocarditis in 988 th Hospital of Chinese People′s Liberation Army Joint Logistics Support Force from May 2017 to August 2018 were selected and divided into the observation group and the control group,with 100 cases in each group.All children received the comprehensive treatment measures such as oxygen inhalation,antioxidant free radicals,antiviral,antiarrhythmic,maintaining water electrolyte and acid-base balance.Based on this,the children in the control group were given fructose 1,6-diphosphate(100-250 mg·kg^-1 ,intravenous drip,once a day) and coenzyme Q10 (0.4 g,oral,twice a day);and the course of treatment was two weeks.The children in the observation group were given creatine phosphate(0.5-1.0g) intravenously within 30-45 minutes,once a day for two weeks.The levels of serum creatine kinase(CK),creatine kinase isoenzyme (CK-MB),lactate dehydrogenase (LDH) and cardiac troponin T (cTnT) of children in the two groups were detected before and after treatment.The therapeutic effect and adverse reactions were compared between the two groups.Results There was no significant difference in the levels of serum CK,CK-MB,LDH and cTnT of children between the two groups before treatment(P>0.05).The levels serum of CK,CK-MB,LDH and cTnT of children after treatment were significantly lower than those before treatment(P<0.05).After treatment,the levels of serum CK,CK-MB,LDH and cTnT of children in the observation group were significantly lower than those in the control group (P<0.05).After treatment,the total effective rate of children in the observation group and the control group was 98.00%(98/100) and 90.00%(90/100),respectively.The total effective rate of children in the observation group was significantly higher than that in the control group (χ^2=4.343,P<0.05).No severe adverse reactions were found in the two groups.Conclusion Creatine phosphate sodium has definite clinical effect and high safety in the treatment of viral myocarditis in children.