摘要
目的:观察卡托普利联合小剂量胺碘酮对病毒性心肌炎(VMC)合并室性心律失常(VA)患儿心电图、心肌损伤标记物和心功能的影响。方法:将118例VMC合并VA患儿随机分为观察组(n=60例)和对照组(n=58例),两组均常规抗病毒和营养心肌治疗,对照组在其基础上给予小剂量胺碘酮治疗,观察组在对照组基础上给予卡托普利治疗,两组疗程2周。观察两组治疗前后动态心电图检查、心肌损伤标记物和心功能的变化情况;并统计两组临床疗效和不良反应。结果:观察组VA和MVC治疗的总有效率显著高于对照组(P均<0.05);两组治疗后PVC、NSVT发生频率较治疗前显著降低,心率变异性(HRV)相关参数(SDNN、RMSSD、SDANN和PNN50)较治疗前均显著升高,观察组治疗后以上指标均优于对照组(P<0.05);两组治疗后血浆CK-MB、CK、cTnI、LDH和AST较治疗前均显著降低,观察组治疗后以上心肌损伤标记物水平均低于对照组(P<0.05)。两组治疗后LVEF、FS和E/A较治疗前均显著升高(P<0.05),LVEDD和LVESD均较治疗前显著降低(P<0.05),观察组治疗后以上指标均优于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:卡托普利联合小剂量胺碘酮能够促进VMC合并VA患儿心律转复,改善HRV,还能加强心肌保护,提高心功能,疗效确定且安全性好。
ObjectiveTo observe the effects of captopril combined with amiodarone on captopril combined with amiodarone on electrocardiogram, myocardial injury markers and cardiac function in viral myocarditis （VMC） children with ventricular arrhythmia （VA）. Methods：118 children with VMC and VA were randomly divided into the observation group （ n =60 cases） and the control group （ n =58 cases）. Both groups received conventional antiviral and nutritional myocardial therapy, and the control group received low-dose amiodarone treatment on the basis of which the observation group received captopril treatment on the basis of the control group, with a course of 2 weeks in both groups. The changes of dynamic ecg, markers of myocardial injury and cardiac function were observed before and after treatment. The clinical efficacy and adverse reactions of the two groups were also calculated. Results：The total effective rate of VA and MVC in the observation group was significantly higher than that in the control group （ P 〈0.05）. After treatment, the frequency of PVC and NSVT in the two groups was significantly lower than that before treatment, and the HRV related parameters （SDNN, RMSSD, SDANN and PNN50） were significantly higher than that before treatment. Plasma CK-MB, CK, cTnI, LDH and AST were significantly reduced after treatment in both groups, and the levels of myocardial injury markers in the observation group were lower than those in the control group （ P 〈0.05）. LVEF, ventricular short-axis shortening （FS） and E/A were significantly increased after treatment in both groups （ P 〈0.05）, LVEDD and LVESD were significantly decreased after treatment in both groups （ P 〈0.05）, and the above indicators in the observation group were better than those in the control group （ P 〈0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （ P 〉0.05）. Conclusion：Cap topril combined with small dose of amiodarone can promote the cardi
作者
李梅
李晓丽
Li Mei;Li Xiaoli(Yan＇an University Affiliated Hospital,Yan＇an 716000)
出处
《陕西医学杂志》
CAS
2018年第11期1496-1499,共4页
Shaanxi Medical Journal
