不同剂量伊伐布雷定治疗病毒性心肌炎患儿的临床疗效及安全性  

Different Doses of Ivabradine in the Treatment of Viral Myocarditis in Children

作　　者：王志军 程艳超[1] 范旭芳 郝海菊 Wang Zhijun;Cheng Yanchao;Fan Xufang;Hao Haiju(The Third Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院,河南郑州450052

出　　处：《儿科药学杂志》2020年第7期27-30,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨不同剂量伊伐布雷定治疗病毒性心肌炎(VMC)患儿的临床疗效及安全性。方法:选取2017年12月至2018年11月我院收治的病毒性心肌炎患儿84例,按就诊顺序单双号分为对照组和观察组各42例。对照组给予盐酸伊伐布雷定片2.5 mg,观察组给予盐酸伊伐布雷定片5 mg,2次/天,连续给药2周,比较两组临床疗效,观察治疗前后血清心肌肌钙蛋白I(cTnI)、心肌肌钙蛋白T(cTnT)、B型钠尿肽前体(NT-proBNP)水平及心率(HR),并记录不良反应发生情况。结果:观察组临床总有效率(90.48%)高于对照组(76.19%),差异有统计学意义(P<0.05)。两组患儿治疗后cTnI、cTnT、NT-proBNP、HR水平均低于治疗前(P<0.05),且治疗后观察组cTnI、cTnT、NT-proBNP、HR水平均显著低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05),均较轻微,无需停药处理。结论:伊伐布雷定治疗VMC患儿的临床疗效显著,较大剂量的伊伐布雷定可获得更好的治疗效果,安全可行,具有较高的临床应用价值。Objective:To probe into the clinical efficacy and safety of different doses of ivabradine in the treatment of viral myocarditis(VMC)in children.Methods:Eighty-four children with VMC admitted to our hospital from Dec.2017 to Nov.2018 were selected to be divided into the control group and the observation group via the admission sequence,with 42 cases in each group.The control group was given ivabradine hydrochloride of 2.5 mg,and the observation group received ivabradine hydrochloride of 5 mg,twice a day for 2 weeks.The clinical efficacy of two groups was compared.The serum cardiac troponin I(cTnI),cardiac troponin T(cTnT),B-type natriuretic peptide precursor(NT-proBNP)levels,and heart rate(HR)were observed before and after treatment.The adverse drug reactions were recorded.Results:The total effective rate of the observation group(90.48%)was higher than that of the control group(76.19%),with statistically significant difference(P<0.05).After treatment,the levels of cTnI,cTnT,NT-proBNP and HR in the observation group were significantly lower than those in the control group(P<0.05).Adverse drug reactions in two groups were relatively mild,no drug withdrawal was required,and the difference was not statistically significant(P>0.05).Conclusion:The clinical efficacy of ivabradine in the treatment of VMC in children is significant.Higher dose of ivaredine can achieve better therapeutic effects,which is safe and feasible,and has higher clinical application value.

关 键 词：伊伐布雷定 病毒性心肌炎 心率 不良反应 

分 类 号：R725.4[医药卫生—儿科]