二磷酸果糖治疗小儿先天性心脏病合并心力衰竭的疗效观察

摘要

Objective To observe the curative effect of fructose diphosphate (FDP) in children patients with congenital heart disease (CHD) complicating heart failure (HF).Methods The children patients with CHD complicating HF (n=150) were randomly divided into observation group and control group (eachn=75). The control group was given digitalis, furosemide and captopril other conventional treatment, and observation group was additionally given FDP intravenous drip [70 mg/(kg·min)]. The curative effect, heart function indexes and adverse reactions were compared in 2 groups after treatment for 5 d.Results There were 45 cases with significant efficacy, 27 with curative effect, and 3 without curative effect. The effectual rate was 60.0% and total effective rate was 96.0% in observation group. There were 36 cases with significant efficacy, 27 with curative effect, and 12 without curative effect. The effectual rate was 48.0% and total effective rate was 82.7% in control group. The difference was statistically significant between 2 groups (P<0.05). The comparison in heart function indexes before and after treatment showed that left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESd) and stroke volume (SV) were significantly improved in 2 groups (P<0.05). The improvements of LVEF and LVESd were more significant in observation group after treatment (P<0.05). The incidence of adverse reactions was lower in observation group than that in control group (P<0.05).Conclusion FDP can significantly relieve clinical symptoms and improve heart function in children patients with CHD complicating HF.%目的：观察二磷酸果糖在治疗小儿先天性心脏病合并心力衰竭（心衰）的疗效。方法将150例小儿先天性心脏病合并心衰的患儿随机分为观察组和对照组各75例，对照组患儿接受洋地黄、呋塞米以及卡托普利等常规治疗，观察组在常规治疗的基础上加二磷酸果糖输液泵静脉滴注，70 mg/（kg·min），治疗5 d后比较两组临床疗效、心功能指标及不良反应。结果观察组显效45例，有效27例，无效3例，显效率60.0%，总有效率为96.0%；对照组显效36例，有效率27例，无效12例，显效率48.0%，总有效率为82.7%。观察组显效率及总有效率均显著高于对照组，差异有统计学意义（P＜0.05）。两组治疗前后心功能各项参数比较，左室射血分数（LVEF）、左室收缩末期内径（LVESD）及每搏输出量（SV）均明显改善（P＜0.05）。但观察组治疗后LVEF和LVESD均较对照组改善更为明显，差异具有统计学意义（P＜0.05）。观察组不良反应发生率少于对照组（P＜0.05）。结论二磷酸果糖可显著提高小儿先天性心脏病合并心衰的临床症状，改善心功能。