磷酸肌酸钠联合卡托普利治疗儿童病毒性心肌炎的疗效观察  

Effect of phosphate sodium and captopril in the treatment of children with viral myocarditis

作　　者：林元涛 曾晓玲[1] 陈亮[1] 徐艳[1] 张燕[1] 

机构地区：[1]自贡市第一人民医院儿科,四川省自贡643000

出　　处：《中国基层医药》2015年第12期1823-1825,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：观察磷酸肌酸钠联合卡托普利治疗儿童病毒性心肌炎的临床疗效及对血浆血管紧张素Ⅱ和氧自由基的影响，为临床治疗提供借鉴。方法选择80例符合入组标准的儿童病毒性心肌炎作为研究对象，按随机数字表法分为观察组40例和对照组40例，两组均进行常规方法治疗，包括休息、维生素 C、抗病毒药物和抗菌剂、营养心肌代谢药药物，对照组再给予卡托普利0．5 mg／kg，2次／d，观察组再给予磷酸肌酸钠联合卡托普利治疗，卡托普利同对照组，磷酸肌酸钠0．5～1 g／d，1次／d，两组均以4周为1个疗程，治疗前后采用放射免疫分析法检测血浆血管紧张素Ⅱ浓度，采用超声心动图检查仪检测心功能指标（心脏射血分数EF、心室短轴缩短率 FS、二尖瓣舒张晚期血流速度峰值与心脏舒张功能二尖瓣舒张早期血流速度峰值比值VA ／TE），进行血清丙二醛（MDA）和超氧化物歧化酶（SOD）检测，评价两组患者临床疗效及心电图疗效。结果观察组的临床疗效及心电图疗效为95％、90％，均明显优于对照组的70％、70％，差异均有统计学意义（χ^2＝9．367、8．571，均 P ＜0．05）。观察组和对照组治疗后 EF、FS、SOD 较治疗前明显升高（t ＝11．689、8．447、9．524和7．714、7．985、6．166，均P ＜0．01），血浆血管紧张素Ⅱ浓度、VA ／TE、血清 MDA 较治疗前明显降低（t ＝17．572、5．772、9．744和9．228、3．553、3．855，均 P ＜0．05），观察组治疗后 SOD 明显高于对照组（t ＝3．932，P ＜0．05），VA ／TE、MDA、血管紧张素Ⅱ浓度明显低于对照组（t ＝3．446、3．633、10．315，均 P ＜0．05）。结论磷酸肌酸钠联合卡托普利能够协同改善病毒性心肌炎患儿心功能，与其降低血浆血管紧张素Ⅱ浓度及清除自由基有关，显著提高常规疗法的临床疗效及心电图疗效，是治疗儿童�Objective To observe the effect and influence on plasma angiotensin Ⅱ and oxygen radicals in the treatment of children with viral myocarditis by phosphate sodium and captopril,provide reference for clinical treat-ment.Methods 80 children with viral myocarditis met the admissions criteria were randomly divided into the obser-vation group（40 cases）and the control group （40 cases）,both group were received conventional therapy,which included rest,vitamin C pin,antiviral and antimicrobial agents,nutritional medicine myocardial metabolism of drugs. The control group was given captopril 0.5mg/kg,bid,the observation group was given phosphate sodium and capto-pril,phosphate sodium 0.5 -1g/d,qd,both groups had been treated for 4 weeks for a course.Plasma angiotensin Ⅱwere detected by radioimmunoassay.The EF,FS,VA /TE were detected by echocardiography instrument.The blood were collected for detecing MDA and SOD.The clinical efficacy and electrocardiogram efficacy were evaluated. Results The clinical efficacy and electrocardiogram efficacy of observation group were 95%,90%,the control group were 70%,70%,and the difference was statistically significant（χ^2 =9.367,8.571,both P 〈0.05）.The EF,FS,SOD of the observation group and the control group after treatment was significantly higher than those of before treatment （t =11.689,8.447,9.524 and 7.714,7.985,6.166,all P 〈0.01）.The plasma angiotensin Ⅱ,VA /TE,MDA were significantly lower than those of before treatment（t =17.572,5.772,9.744 and 9.228,3.553,3.855,all P 〈0.05）. The SOD of the observation group after treatment was significantly higher than that of the control group（t =3.932, P 〈0.05）,VA /TE,MDA were significantly lower than that of the control group（t =3.446,3.633,10.315,all P 〈0.05）.Conclusion The method containing phosphate sodium and captopril can collaboratively improve heart func-tion,which may be relate to the decrease in plasma angiotensin Ⅱ and scavenging oxygen free radicals.The method can significantly improve the

关 键 词：心肌炎 儿童 磷酸肌酸钠 卡托普利 

分 类 号：R259.422.1[医药卫生—中西医结合]