利巴韦林联合磷酸肌酸钠治疗小儿病毒性心肌炎的疗效观察

摘要

Objective To observe and evaluate the clinical effect of ribavirin combined with creatine phosphate in the treatment of viral myocarditis (VMC) in children.Methods A total of 106 children with viral myocarditis who were admitted to the Department of Pediatrics in Dongguan Tangxia Hospital and Guangzhou Red Cross Hospital from January 2015 to December 2017 were selected and were randomly divided into two groups.53 children in the control group were given intravenous infusion of ribavirin;53 children in the observation group were treated with intravenous infusion of creatine phosphate,once a day for 2 weeks.And the clinical effects were compared between the two groups after treatment.Results The total effective rate was 94.34％ in the observation group,significantly higher than 79.25％ in the control group (x2=5.267 1,P＜0.05).The levels of LDH,HBDH,AST,cTnI after treatment in both groups were significantly lower than those before treatment (P＜0.05);the levels of LDH,HBDH,AST,cTnⅠ in the observation group were significantly lower than those in the control group (P＜0.05).The levels of CD3+,CD4+,and CD4+/CD8+ after treatment in the two groups were significantly higher than those before treatment (P＜0.05);the levels of CD3+,CD4~,and CD4+/CD8+ in the observation group were higher than those in the control group (P＜0.05).The levels of TNF-α,IL-6,and IL-17 after treatment in the two groups were significantly lower than those before treatment (P＜0.05);the levels of TNF-α,IL-6,and IL-17 in the observation group were significantly lower than those in the control group (P＜0.05).Conclusion Ribavirin combined with creatine phosphate has significant curative effect on viral myocarditis in children.It effectively reduces the level of myocardial enzymes and inflammation in children and significantly improves the immune function of children.It is worthy of clinical promotion.%目的 观察评价利巴韦林联合磷酸肌酸钠治疗小儿病毒性心肌炎(VMC)的临床效果.方法 选择2015年1月至2017年12月期间东莞市塘厦医院儿科及广州市红十字会医院儿科收治的VMC患儿106例,并随机分为两组,对照组53例给予利巴韦林静脉滴注治疗;观察组53例在对照组基础上加用磷酸肌酸钠静滴,1次/d,疗程2周,并比较两组治疗后的临床效果.结果 观察组总有效率为94.34％显著高于对照组的79.25％(x2=5.2671,P＜0.05);两组LDH、HBDH、AST、cTnⅠ水平均显著低于治疗前(均P＜ 0.05),观察组LDH、HBDH、AST、cTnⅠ水平均显著低于对照组,差异均有统计学意义(均P＜ 0.05);两组CD3+、CD4+和CD4+/CD8+水平均明显的高于治疗前(均P＜0.05),观察组CD3+、CD4+和CD4+/CD8+水平均高于对照组(均P＜ 0.05);两组TNF-α、IL-6及IL-17水平均显著低于治疗前(均P＜ 0.05),观察组TNF-α、IL-6及IL-17水平均明显的低于对照组(均P＜0.05).结论 利巴韦林联合磷酸肌酸钠治疗小儿VMC具有显著的疗效,有效地降低患儿心肌酶水平及炎症的发生,并显著地提高患儿免疫功能,值得临床大力推广.