磷酸肌酸钠治疗小儿病毒性心肌炎的临床观察(1)
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【摘要】目的 探讨磷酸肌酸钠对小儿病毒性心肌炎的临床疗效，为改善该病预后以及寻求适宜的治疗药物提供依据。方法 回顾性分析我院2006年1月-2011年2月收治的235例VMC患者的临床资料，根据其治疗方案将患儿分为治疗组和对照组，治疗组定义为给予维生素C、复方丹参注射液和磷酸肌酸钠治疗；对照组定义为给予维生素C和复方丹参注射液治疗。对患儿的发病性别、发病年龄、发病季节、前驱感染史、临床症状和体征、辅助检查(包括ECG和HOLTER检查、心肌酶检查等)及临床疗效等情况进行分析比较。结果 治疗组从治疗的总有效率、ECG和HOLTER的阳性检出情况以及心肌酶CK-MB变化等方面都优于对照组，两组总有效率比较差异有统计学意义(X2=9.485，P <0.05)。结论 常规治疗加用磷酸肌酸钠取得较好疗效，可将磷酸肌酸钠作为辅治小儿VMC药物。
【关键词】 病毒性心肌炎；小儿；磷酸肌酸钠
【Abstract】Objective To discuss sodium phosphocreatine against the disease clinical curative effect of VMC., In order to provide clinical basis for the future improving outcomes and appropriate cure medicine of VMC. Methods we collected and retrospective analyzed clinical data of 235 patients who had been proved to be VMC from 2006.1 to 2011.2 of Zhengzhou city children’s hospital. Divided the patients into two groups to observe the medicine curative effect: control group gave vitaminC、Compound danshen, therapy group gave vitaminC、Compound danshen and sodium phosphocreatine. On the patients onset gender, age, disease pathogenesis season, precursor infection history, clinical symptoms and signs, auxiliary examination (including ECG and HOLTER inspection, myocardial enzymes check, chest radiograph and heart color dopplar ultrasound examination, virus antibody detection, cTnI, cTnT, CRP, NT - proBNP inspection and routine blood, etc.) and clinical curative effect and other circumstances were compared. Results All the results of ECG , HOLTER and cardiac muscle enzyme CK-MB disappearance were better in treatment group than in control group. There was a significant difference between these two groups(X2=9.485，P <0.05)。Conclusions On the grounding of conventional therapy, sodium phosphocreatine can action an assisting medicine.
【Key words】Viralm yocarditis; Children; Sodium phosphocreatine
病毒性心肌炎(VMC)是指人体感染嗜心性病毒后引起的心肌非特异性间质性炎症，可导致心肌细胞坏死、水肿、纤维化和凋亡，造成心脏结构功能变化和心电生理紊乱，远期并发症可表现为扩张性心肌病，有的患者可伴有心内膜炎症改变或者心包[1-2] 。作为儿科常见的心脏疾患之一，近年来发病率有逐年上升趋势[3]。VMC患者心电图的改变具有多变性和多样性等特点[4]，同时，某些酶类蛋白在发生VMC患者的心肌病变中也可以有明显改变，现在，临床上诊断VMC主要以生化指标、免疫指标、胸片、心脏彩超以及心电图等检查结果为参考依据进行综合分析和判断。至今VMC尚无特效治疗，传统治疗通常采用抗病毒对症治疗、营养保护心肌以及中医药治疗等，本文在传统药物治疗基础上加用磷酸肌酸钠辅助治疗小儿病毒性心肌炎 ......
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