摘要
目的探讨参麦注射液辅助治疗小儿肺炎合并心力衰竭的疗效及对心型脂肪酸结合蛋白(H-FABP)、肌钙蛋白I(cTnI)、胰岛素样生长因子(IGF-1)水平的影响。方法将134例肺炎合并心力衰竭患儿随机分为治疗组67例和对照组67例,对照组给予抗感染、吸氧、利尿、强心、镇静等治疗,治疗组在对照组治疗基础上加用参麦注射液治疗。记录2组患儿咳嗽消失时间、肝脏回缩时间、肺啰音消失时间、呼吸平稳时间、心率平稳时间和发绀消失时间,应用彩色多普勒超声诊断仪检测心功能指标[左心室射血分数(LVEF)、左室舒张末内径(LVDD)、舒张期室间隔厚度(IVST)和二尖瓣E峰峰值血流速度/A峰峰值血流速度比值(E/A)],应用全自动生化分析仪检测心肌酶谱中乳酸脱氢酶(LDH)、肌酸磷酸激酶同工酶(CK-MB)、肌酸磷酸激酶(CK)和谷草转氨酶(AST)水平,采用酶联免疫吸附法检测H-FABP和IGF-1水平,应用微粒子免疫发光法检测cTnI水平。结果治疗后治疗组咳嗽消失时间、肝脏回缩时间、肺啰音消失时间、呼吸平稳时间、心率平稳时间和发绀消失时间均明显短于对照组(P均<0.05)。2组治疗后LVDD、IVST及LDH、CK-MB、CK、AST、H-FABP、cTnI水平均明显降低(P均<0.05),LVEF、E/A及IGF-1水平均明显升高(P均<0.05),且治疗组各指标改善情况均明显优于对照组(P均<0.05)。结论参麦注射液能够有效改善肺炎合并心力衰竭患儿的临床症状体征及心功能,且能够显著降低H-FABP和cTnI水平,升高IGF-1水平,提示H-FABP、IGF-1、cTnI在疾病的治疗和预后评估中发挥重要作用。
Objective It is to explore the curative effect of assistant therapy with Shenmai injection on child pneumonia with heart failure and on the levels of heart type fatty acid binding protein （ H-FABP）, troponin I （ cTnI）, insulin-like growth factor （ IGF-1 ）. Methods 134 cases of children with pneumonia with heart failure were randomly divided into treat- ment group （n = 67） and control group （n = 67）, the control group was given therapy such as anti-infection, oxygen, diu- resis, cardiac and sedation, additionally the treatment group was treated with Shenmai injection based on the treatment in the control group. The cough disappeared time, liver retraction time, pulmonary rales disappeared time, time to smooth breathing and steady heart rate and cyanosis disappear time were recorded, the cardiac function indexes [ left ventricular e- jection fraction （LVEF） , left ventricular end-diastolic diameter （ LVDD）, diastolic ventricular septal thickness （IVST） and mitral E peak value of blood flow velocity/A peak value of blood flow velocity （E/A） ] were detected by color doppler ultrasonic examination, the levels of myocardial enzyme lactate dehydrogenase （LDH）, creatine phosphokinase isoenzyme （CK-MB）, creatine phosphokinase （CK） and aspertate aminotransferase （AST） were determined by full automatic bio- chemical analyzer, the levels of H-FABP and IGF-1 was detected by enzyme-linked immunosorbent method, the level of cT- nI was deteeted by micro particle immune luminescence detection. Results After treatment, the cough disappeared time,liver retraction time, pulmonary rales disappeared time, time to smooth breathing and steady heart rate and cyanosis disap- pear time were shorter in the treatment group than those in the control group （ P 〈 0.05 ）. The levels of LVDD, IVST, LDH, CK-MB, CK, AST, H-FABP, cTnI were significantly decreased （P 〈 0.05 ）, and the levels of LVEF, E/A and IGF-1 were significantly increased in both groups after treatment （P 〈 O. 05） , the improvements of these indexes in the treatment group were significantly better than those in the control group （ P 〈 0.05 ）. Conclusion Shenmai injection can ef- fectively improve clinical symptoms and signs and cardiac function, and can significantly reduce the Jevels of H-FABP and cTnI, increase the levels of IGF-1 in the treatment of children with pneumonia with heart failure, which showed that H- FABP, IGF-1, cTnI plays an important role in the treatment and prognosis assessment of the disease.
出处
《现代中西医结合杂志》
CAS
2018年第2期139-142,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
河北省卫生厅指导项目(20110231)
