左卡尼汀对小儿病毒性心肌炎心肌细胞功能保护的量效关系研究  

Study on the dose-effect relationship of left carnitine on cardiomyocyte function protection in children with viral myocarditis

作　　者：黄静[1] 吴园园[1] 夏天和[1] 何旭香[1] 

机构地区：[1]温州医科大学附属第二医院育英儿童医院小儿心内科

出　　处：《中国生化药物杂志》2017年第5期332-334,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的观察不同剂量左卡尼汀治疗小儿病毒性心肌炎的心肌细胞功能保护作用。方法选取94例病毒性心肌炎患儿,按随机数表法分为大剂量组与小剂量组,各47例。2组均应用1,6二磷酸果糖（100~250 mg/kg,加入150 m L的10%葡萄糖中静脉滴注,1次/d）联合左卡尼汀治疗,大剂量组左卡尼汀100 mg/kg,小剂量组50 mg/kg,均加入150 m L的5%葡萄糖中静脉滴注,1次/d。比较2组总有效率、肌酸激酶（CK）、肌酸激酶同功酶（CK-MB）、乳酸脱氢酶（LDH）、心脏射血分数（EF）、心室短轴缩短率（FS）及不良反应总发生率。结果 2组总有效率分别为93.62%、87.23%,差异无统计学意义。2组治疗2周后的CK、CK-MB、LDH水平均明显降低（P〈0.05）,EF、FS均明显升高（P〈0.05）;大剂量组与小剂量组治疗后CK、CK-MB、LDH、EF、FS的差异均无统计学意义。大剂量组不良反应总发生率为25.53%,低于小剂量组的8.51%（P〈0.05）。结论小剂量左卡尼汀在病毒性心肌炎患儿中的应用可有效清除自由基、保护心肌细胞功能并改善心肌能量代谢与心功能,且较之大剂量组更安全。Objective To observe the protective effect of different doses of left carnitine on cardiomyocyte function in children with viral myocarditis.Methods94 cases of children with viral myocarditis were selected and divided into observation group and control group according to the random number table, 47 cases in each group.Both groups were treated with fructose 1,6-diphosphate（100~250mg/kg, add 150mL of 10% glucose in intravenous infusion, 1times/d） combined with left carnitine.Large dose group of left carnitine 100 mg/kg, low dose group 50mg/kg, all added 150mL of 5% glucose intravenous infusion, 1 times/d.The total effective rate, creatine kinase（CK）, creatine kinase isoenzyme （CK-MB）,lactate dehydrogenase （LDH）, cardiac ejection fraction（EF）, ventricular short axis shortening （FS） And the total incidence of adverse reactions were compared between two groups.ResultsThe total effective rates of two group were 93.62% and 87.23%.The level of CK,CK-MB,LDH in two groups were significantly decreased after treatment of two weeks（P〈0.05）, EF, FS were increased after treatment of two weeks（P〈0.05）.There was no significant difference in CK, CK-MB, LDH, EF and FS between the high dose group and the low dose group after treatment of two weeks.The overall incidence of adverse reactions in the high dose group was 25.53%, which was lower than that in the low dose group （8.51%,P〈0.05）.ConclusionThe use of low-dose left carnitine in children with viral myocarditis can effectively remove free radicals, protect cardiomyocyte function and improve myocardial energy metabolism and cardiac function, and safer than high-dose groups.

关 键 词：病毒性心肌炎 小儿 左卡尼汀 心肌细胞 剂量 

分 类 号：R725.4[医药卫生—儿科]