磷酸肌酸钠联合利巴韦林对感染性心肌炎的疗效  

Effect of sodium creatine phosphate combined with ribavirin on treatment of infectious myocarditis

作　　者：丛晓辉[1] 鲁方圆 祖力皮亚·加怕尔 石琳[1] CONG Xiao-hui;LU Fang-yuan;Zulipiya·JIAPAER;SHI Lin(Children's Hospital Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院心血管内科,北京100020 [2]新疆维吾尔自治区和田地区人民医院儿科,新疆和田848000

出　　处：《中华医院感染学杂志》2019年第14期2117-2120,2129,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(82052561)

摘　　要：目的探讨磷酸肌酸钠联合利巴韦林对感染性心肌炎患儿临床疗效及血清调节性T细胞、肌酸激酶同工酶(CK-MB)和肌钙蛋白的影响。方法收集2014年10月-2018年1月医院收治的感染性心肌炎患儿86例,按照随机数字表法分为观察组和对照组,每组各43例。对照组给予利巴韦林治疗,观察组在对照组基础上采用磷酸肌酸钠联合治疗,连续治疗2周。比较两组患者临床疗效及不良反应发生情况。分析两组患者治疗前后心肌酶水平、肌钙蛋白水平以及免疫调节性T细胞(Treg细胞)/CD4^+T细胞(Treg/CD4^+T)水平变化情况。结果结果显示,观察组总有效率显著高于对照组,两组患儿不良反应发生率比较无统计学差异。治疗后,两组患者心肌酶指标[谷草转氨酶(AST)、肌酸激酶(CK)、CK-MB、血清乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)]、肌钙蛋白(cTnI、cTnT)、Treg/CD4^+T及肿瘤坏死因子-β(TNF-β)水平均显著改善(P<0.05),且观察组改善效果更为明显(P<0.05)。结论磷酸肌酸钠联合利巴韦林治疗感染性心肌炎患儿临床效果确切,对心肌损伤及免疫功能具有一定改善作用,值得进一步研究探讨。OBJECTIVE To explore the clinical effect of sodium creatine phosphate combined with ribavirin on treatment of children with infectious myocarditis and its influence on serum regulatory T cells, creatine kinase-MB(CK-MB) and troponin. METHODS A total of 86 children with infectious myocarditis who were treated in hospitals from Oct 2014 to Jan 2018 were enrolled in the study and randomly divided into the observation group and the control group, with 43 cases in each group. The control group was treated with ribavirin, while the observation group was treated with sodium creatine phosphate combined with ribavirin for 2 consecutive weeks. The clinical curative effects and incidence of adverse reactions were compared between the two groups of patients. The levels of myocardial enzyme, troponin and regulatory T cells Treg cells/CD4^+T cells(Treg/CD4^+T) were observed and compared between the two groups of patients before and after the treatment. RESULTS The total effective rates of the observation group was significantly higher than that of the control group;there was no significant difference in the incidence of adverse reaction ns between the two groups of children. The levels of myocardial enzyme indexes aspartate aminotransferase(AST), creatine kinase(CK), CK-MB, serum lactate dehydrogenase(LDH), hydroxybutyrate dehydrogenase(HBDH), troponins(cTnI, cTnT), Treg/CD4^+T and tumor necrosis factor β(TNF-β)of the two groups of patients were significantly improved after the treatment, and the above indexes were improved more significantly in the observation group than in the control group(P<0.05). CONCLUSION Sodium creatine phosphate combined with ribavirin can achieve remarkable clinical effect on treatment of the children with infectious myocarditis and improve the myocardial injury and immune function, and it is worthy to be further promoted.

关 键 词：磷酸肌酸钠 利巴韦林 感染性心肌炎 

分 类 号：R542.2[医药卫生—心血管疾病]