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目的观察左卡尼汀治疗小儿支原体肺炎(mycoplasma pneumonia,MP)合并心肌损害的临床效果。方法选择2011年2月-2012年12月收治的MP合并心肌损害患儿86例,随机分为对照组和观察组各43例。入院后两组均予以抗感染治疗,对照组给予能量合剂及维生素C静脉滴注,乳糖酸阿奇霉素注射液10 mg.kg-1.d-1加入5%葡萄糖注射液配置成浓度为1 mg/ml的溶液静脉滴注,连续治疗5 d,间隔4 d再连用3 d。观察组在对照组基础上给予左卡尼汀100 mg/kg加入5%葡萄糖注射液100 ml静脉滴注,1次/d,连续治疗2周后观察疗效。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗前CK-MB、CK、AST、LDH、肌钙蛋白对照组分别为(69.0±14.7)、(360.9±113.0)、(146.0±60.1)、(367.9±96.0)U/L、(2.18±1.09)ng/ml,观察组分别为(68.2±15.3)、(372.5±124.5)、(150.1±59.8)、(378.0±95.4)U/L、(2.16±1.07)ng/ml;治疗后CK-MB、CK、AST、LDH、肌钙蛋白对照组分别为(16.9±7.5)、(195.4±60.1)、(86.0±23.4)、(307.6±55.9)U/L、(0.80±0.31)ng/ml,观察组分别为(16.2±5.9)、(76.5±19.2)、(28.3±13.0)、(125.6±44.3)U/L、(0.29±0.17)ng/ml。治疗前后CK-MB、CK、AST、LDH、肌钙蛋白两组组内比较差异均有统计学意义(均P<0.05),治疗后CK、AST、LDH、肌钙蛋白组间比较差异均有统计学意义(均P<0.05)。心电图异常率治疗前对照组58.14%,观察组60.47%;治疗后对照组34.88%,观察组13.95%。治疗前后心电图异常率两组组内比较差异均有统计学意义(均P<0.05),治疗后心电图异常率组间比较差异有统计学意义(P<0.05)。结论左卡尼汀治疗MP合并心肌损害可有效控制心肌损害,改善心脏功能,效果满意。
Objective To observe the clinical effect of levocarnitine on mycoplasma pneumonia (MP) combined with myocardial damage. Methods Totally 86 children with MP complicated with myocardial damage admitted from February 2011 to December 2012 were randomly divided into control group and observation group, with 43 cases in each group. After admission, both groups were treated with anti-infective therapy. The control group was given intravenous infusion of vitamin C and vitamin C, and 10 mg.kg-1.d-1 lactate azithromycin injection was added into 5% dextrose injection to a concentration of 1 mg / ml solution intravenously, continuous treatment of 5 d, 4 d interval and then use 3 d. The observation group was given lcarnitine 100 mg / kg on the basis of the control group with 5% dextrose injection 100 ml intravenously once a day for 2 weeks. The curative effect was observed. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The levels of CK-MB, CK, AST, LDH and troponin in the control group before treatment were 69.0 ± 14.7, 360.9 ± 113.0, 146.0 ± 60.1, 367.9 ± 96.0 U / L, 2.18 ± 1.09) ng / ml in the observation group and (68.2 ± 15.3), (372.5 ± 124.5), (150.1 ± 59.8) and (378.0 ± 95.4) U / L in the observation group (16.9 ± 7.5), (195.4 ± 60.1), (86.0 ± 23.4), (307.6 ± 55.9) U / L and (0.80 ± 0.31) ng / ml in MB, CK, AST, LDH and troponin control groups respectively (16.2 ± 5.9), (76.5 ± 19.2), (28.3 ± 13.0), (125.6 ± 44.3) U / L and (0.29 ± 0.17) ng / ml in the observation group. There were significant differences in CK-MB, CK, AST, LDH and troponin between the two groups before and after treatment (all P <0.05). There were significant differences in CK, AST, LDH and troponin after treatment Statistical significance (all P <0.05). The ECG abnormality rate was 58.14% in control group and 60.47% in observation group before treatment, 34.88% in control group and 13.95% in observation group. Before and after treatment, ECG abnormalities in the two groups were significantly different (all P <0.05), ECG abnormalities after treatment was significantly different (P <0.05). Conclusion L-carnitine combined with myocardial damage can effectively control myocardial damage and improve cardiac function with satisfactory results.