葡萄糖酸锌联合消旋卡多曲辅助治疗小儿轮状病毒性肠炎的临床效果及对心肌酶、免疫功能的影响

摘要

目的 观察葡萄糖酸锌联合消旋卡多曲辅助治疗小儿轮状病毒性肠炎的临床效果及对心肌酶、免疫功能的影响.方法 将120例轮状病毒性肠炎患儿随机分为对照组和观察组各60例,两组均给予常规治疗,观察组同时给予葡萄糖酸锌联合消旋卡多曲口服.比较两组治疗总有效率、主要临床症状改善所需时间以及治疗前后心肌酶、炎症因子及T细胞亚群水平.结果 观察组治疗后总有效率为96. 67% ,高于对照组的83. 33% (P＜0.05).观察组的止泻、脱水纠正及退热所需时间均短于对照组(均P＜0.05).治疗后,两组乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶、AST、白细胞介素6水平均低于治疗前,而观察组以上指标均低于对照组(P＜0.05).观察组治疗后CD4 +T细胞比例、CD4 +/CD8 +比值高于对照组, CD8 +T细胞比例低于对照组(P＜0.05).结论 采用葡萄糖酸锌联合消旋卡多曲辅助治疗小儿轮状病毒性肠炎,临床效果显著,可显著减轻心肌损伤程度及炎症程度,改善机体免疫功能.%Objective To investigate the clinical efficacy of zinc gluconate combined with racecadotril and its effect on myocardial enzymes and immune function in children with rotavirus enteritis. Methods A total of 120 children with rotavirus enteritis were randomly divided into control group(60 cases) and observation group(60 cases). Both group received conventional treatment,and the observation group was also orally administered zinc gluconate combined with racecadotril. The total effective rate and duration for main clinical symptoms improvement,as well as the levels of myocardial enzymes,inflammatory factors and T cell subsets before and after treatment,were compared between the two groups. Results After treatment,the total effective rate of the observation group was higher than that of the control group(96. 67% vs 83. 33% ,P＜0. 05). The durations for recovering from diarrhea,dehydration and fever in the observation group were shorter than those in the control group(all P＜0. 05). After treatment,the levels of lactate dehydrogenase,creatine kinase,creatinine kinase MB isoenzyme,AST and interleukin 6 decreased in both groups compared to the levels before treatment(P＜0. 05),and the levels of those indices above in the observation group were lower than the levels in the control group(P＜0. 05). After treatment,the percentage of CD4 +T cells and the ratio of CD4 +/CD8 +in the observation group were higher than those in the control group,and the percentage of CD8 +T cells in the observation group was lower than that in the control group(P＜0. 05). Conclusion For pediatric rotavirus enteritis, zinc gluconate combined with racecadotril can obtain a significant clinical efficacy,significantly reduce the degree of myocardial injury and inflammation,and improve the immune function.