左卡尼汀联合丙种球蛋白对心肌酶谱异常重症手足口病的临床疗效  

Clinical efficacy of levocarnitine combined with gamma globulin on severe hand-foot-mouth disease with abnormal myocardial enzyme levels

作　　者：张保霞[1] 张晓[1] ZHANG Baoxia;ZHANG Xiao(Department of the Third Ward of Pediatrics,Nanyang First People′s Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院儿三科,南阳473000

出　　处：《西北药学杂志》2020年第4期581-585,共5页Northwest Pharmaceutical Journal

摘　　要：目的探讨使用左卡尼汀联合丙种球蛋白治疗心肌酶谱异常重症手足口病(HFMD)的临床效果。方法将入选的96例重症HFMD患儿,随机均分为对照组(n=48)和联合组(n=48)。2组患儿均给予隔离消毒、补液、吸氧、退热和抗病毒等常规治疗,对照组在常规治疗的基础上给予丙种球蛋白静脉滴注治疗,联合组在对照组治疗的基础上予以左卡尼汀注射液治疗。2组均治疗7 d。于治疗前、后分别测量2组患儿的心功能指标,包括左室射血分数(LVEF)、射血缩短分数(FS)和心脏指数(CI);测定外周血心肌酶谱,包括乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天门冬氨酸氨基转移酶(AST)、超氧化物歧化酶(SOD)、丙二醛(MDA)、可溶性细胞凋亡因子(sFas)及可溶性细胞凋亡因子配体(sFasL);记录2组患儿症状消失时间、心电图恢复时间以及住院时间。结果治疗后,联合组症状消失时间、心电图恢复时间和住院时间均明显短于对照组,差异有统计学意义(P<0.05);联合组的心功能指标(LVEF,FS和CI)均高于对照组,差异有统计学意义(P<0.05);联合组心肌酶谱(LDH、CK、CK-MB和AST)均低于对照组,差异有统计学意义(P<0.05)。治疗后联合组的有效率为93.75%,明显高于对照组的83.33%,差异有统计学意义(P<0.05)。结论左卡尼汀联合丙种球蛋白治疗心肌酶谱异常的重症HFMD患儿更能有效缓解临床症状,降低心肌酶谱和改善心功能。Objective To explore the clinical curative effect of levocarnitine combined with gamma globulin on severe hand-foot-mouth disease(HFMD)with abnormal myocardial enzyme levels.Methods 96 children with severe HFMD were randomly divided into control group(n=48)and combination group(n=48).Both groups were given routine treatment such as isolation disinfection,fluid infusion,oxygen inhalation,defervescence and virussafe.On the basis of routine treatment,the control group was given intravenous infusion of gamma globulin.On the basis of control group,the combination group was given Levocarnitine Injections.The both groups were treated for 7 d.Before and after treatment,the cardiac function indexes of the 2 groups were measured,including left ventricular ejection fraction(LVEF),fractional shortening(FS)and cardiac index(CI).The peripheral blood myocardial enzymes,including lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),aspartate aminotransferase(AST)and superoxide dismutase(SOD),malondialdehyde(MDA),soluble apoptotic factor(sFas)and soluble apoptotic factor ligand(sFasL)were measured.The symptom disappearance time,recovery time of electrocardiogram(ECG)and hospitalization time in the 2 groups were recorded.Results After treatment,the symptom disappearance time,recovery time of ECG and hospitalization time in combination group were significantly shorter than those in control group,the difference is statistically significant(P<0.05).The cardiac function indexes(LVEF,FS and CI)of the combination group were higher than those of the control group,the difference is statistically significant(P<0.05).The myocardial enzymes(LDH,CK,CK-MB and AST)in the combination group were lower than those in the control group,the difference is statistically significant(P<0.05).After treatment,the effective rate of combination group was significantly higher than that of control group(93.75%vs 83.33%),the difference is statistically significant(P<0.05).Conclusion Levocarnitine combined with gamma globulin in the tr

关 键 词：手足口病 心肌酶谱异常 左尼卡汀 丙种球蛋白 疗效 

分 类 号：R978.7[医药卫生—药品]