左卡尼汀治疗柯萨奇A16型病毒感染所致手足口病患儿血清NT-proBNP和BNP水平异常的效果

Effects of Levocarnitine on abnormal NT-proBNP and BNP levels of children with hand, foot and mouth disease caused by Coxsackie virus A16 infection

目的:观察左卡尼汀治疗柯萨奇A16型病毒(CA16型)感染所致手足口病(HFMD)血清氨基末端脑钠肽前体(NT-proBNP)和B型脑钠肽(BNP)水平异常的效果。方法:选取68例CA16型病毒感染后血氨基末端脑钠肽(NT-proBNP)和B型脑钠肽(BNP)异常的HFMD患儿,按照病案号奇偶数随机分为对照组(实施基础治疗)和观察组(基础治疗联合左卡尼汀治疗),比较两组血BNP、NTproBNP、肌酸激酶同工酶(CK-MB)、门冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)等指标水平和心电图、心率变化以及重症转化率等指标水平。结果:(1)治疗前,两组患儿的性别、年龄、病程、心率、心肌酶谱、BNP、NT-proBNP等指标水平比较,差异均无统计学意义(P>0.05)。(2)治疗3d和7d后,观察组患儿治疗总有效率分别为85.3%、100%,均高于对照组的61.8%、94.1%,两组比较差异有统计学意义(P<0.05)。(3)治疗3d后,观察组NT-proBNP和BNP、AST、CK-MB水平低于对照组,差异有统计学意义(P<0.05)。(4)治疗7d后,观察组CK-MB、NT-proBNP、BNP水平和心率恢复时间短于对照组,ECG恢复率高于对照组,差异有统计学意义(P<0.05)。结论:基础治疗联合左卡尼汀治疗柯萨奇A16型病毒感染所致HFMD患儿血NT-proBNP和BNP水平异常的效果优于单纯基础治疗效果,可显著改善患儿BNP、NT-proBNP和心肌酶谱水平,缩短心率恢复时间,提高心电图恢复率。

Objective:To observe effects of Levocarnitine on abnormal serum BNP and NT-proBNP levels of Children with hand, foot and mouth disease (HFMD) caused by Coxsackie virus A16 infection.Methods:68 children with abnormal serum B-type natriuretic peptide (BNP) and animo-ternimal pro-brain natriuretic peptide (NT- proBNP) levels after Coxsackie virus A16 infection were selected and divided into control group and observation group according to odd/even case numbers.The control group was given the basic treatment, while the observation group was given Levocarnitine on the basis of that of the control group.The levels of blood BNP, NT-proBNP, creatine kinase isoenzyme (CK-MB), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH), ECG and heart rate changes, and intensive conversion rate were compared between the two groups.Results:(1)(1) Before the treatment, there were no statistical differences in the gender, age, course of disease, heart rate, myocardial enzymes, BNP, NT-proBNP and other indicators between the two groups (P>0.05).(2) 3 days after the treatment, the total effective rate of the observation group was significantly higher than that of the control group;the levels of NT-proBNP and BNP, AST and CK- MB were lower than those of the control group;and the differences were statistically significant (P<0.05).(3) 7 days after the treatment, the cure rate of the observation group was significantly higher than that of the control group;the CK-MB, NT-proBNP and BNP levels were lower or shorter than those of the control group, the heart rate recovery time was shorter than those of the control group, and the ECG recovery rate was higher than that of the control group;and the differences were statistically significant (P<0.05).Conclusions:For the HFMD children with abnormal serum BNP and NT-proBNP levels caused by Coxsackie virus A16 infection, Levocarnitine based on the basic treatment can significantly improve the BNP, NT-proBNP and myocardial enzyme levels and shorten the heart rate recovery time.Moreover, its effects on the improvements of ECG recovery rate and the total effective rate of treatment are better than simple basic treatment.