西咪替丁佐治小儿过敏性紫癜的疗效

Efficacy of cimetidinein the treatment of allergic purpura in children

目的分析探讨西咪替丁佐治小儿过敏性紫癜的疗效及对心电图心率、QT间期和心率校正的QT间期(QTLc)的影响。方法选取温州市中西医结合医院于2016年6月至2018年6月期间收治的85例过敏性紫癜患儿,按照随机数字表法将所有患儿随机分为对照组和试验组两组,两组患儿均给予维生素C、地塞米松及钙剂等进行综合治疗,试验组患儿在此基础上加用西咪替丁;观察两种治疗方案对患儿心电图心率、QTLc和QT间期的影响,比较两组患儿入院第2天的心肌酶水平和治疗后心律失常发生情况。结果两组患儿入院第2天的肌酸激酶同工酶和肌酸激酶、乳酸脱氢酶、天冬氨酸转氨酶等心肌酶水平比较差异无统计学意义(均P>0.05)。两组患儿治疗前的心电图心率和QTLc、QT间期等指标比较差异无统计学意义(均P>0.05);经过治疗后,试验组患儿的QTLc、QT间期均显著高于治疗前,心电图心率低于治疗前(t值分别为6.384、6.931、6.383,均P<0.05);试验组患儿治疗后的QTLc、QT间期均显著高于对照组患儿,心电图心率低于对照组患儿(t值分别为7.394、7.321、6.283,均P<0.05)。经过治疗后两组患儿的心律失常发生率比较差异无统计学意义(均P>0.05)。试验组患儿的总有效率为97.87%,显著高于对照组患儿的81.58%,差异有统计学意义(χ~2=9.273,P<0.05)。结论西咪替丁佐治小儿过敏性紫癜会使患儿心率减慢并且相对延长其QTLc、QT间期,因此在治疗期间需要密切监测患儿的心电图心率和QTLc、QT间期,避免引起室性心律失常的发生。

Objective To investigate the efficacy of cimetidine in the treatment of allergic purpura in children and its effects on electrocardiogram(ECG) heart rate,QT interval and heart-rate corrected QT interval(QTLc).Methods From June 2016 to June 2018,85 cases of children with allergic purpura treated in Wenzhou Integrated Chinese and Western Medicine Hospital were selected and divided into control group and experimental group randomly according to random number table method.All subjects were treated with vitamin C,dexamethasone and other comprehensive treatment.And children in the experimental group were also treated with cimetidine on this basis.Finally,the effects of the two treatment regimens on ECG heart rate,QT interval and QTLc in the two groups were compared,and the level of myocardial enzyme on the second day after admission and arrhythmia after treatment in the two groups were compared.Results There were no significant differences in the levels of creatine kinase isoenzyme,creatine kinase,lactate dehydrogenase and aspartate aminotransferase between the two groups on the second day of admission(all P>0.05).And no significant differences were found in ECG heart rate,QT interval and QTLc before treatment between the two groups(all P>0.05).After treatment,the indexes of QT interval and QTLc in the experimental group were significantly higher than those before treatment(t=6.384 and 6.931,respectively,both P<0.05),and the heart rate of ECG was significantly lower than that before treatment(t=6.383,P<0.05).In addition,the indexes of QT interval and QTLc in the experimental group were significantly higher than those in the control group(t=7.394 and 7.321,respectively,both P<0.05),and the heart rate of ECG was lower than that in the control group(t=6.283,P<0.05).But no significant difference was found in the incidence of arrhythmia between the two groups after treatment(P>0.05).The total effective rate of the experimental group was also significantly higher than that of the control group(97.87% vs.81.58%,χ~2=9.273,P<0.05).Conclusion Treatment with cimetidine in children with allergic purpura might slow the heart rate of children and relatively extend the QTLc and QT interval.Therefore,it is necessary to closely monitor the ECG heart rate,QT interval and QTLc of children during the treatment with cimetidine to avoid causing ventricular arrhythmia.