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目的:探讨磷酸肌酸钠辅助治疗新生儿缺氧缺血性心肌损害的疗效及对患儿血清白细胞介素-6(IL-6)和心肌酶的影响。方法:80例缺氧缺血性心肌损害新生儿随机分为观察组和对照组。两组均予维持通气、保暖、维持水电解质及酸碱平衡、维持心率血压、营养支持等常规治疗。在此基础上对照组加用1,6二磷酸果糖250 mg·kg-1,ivd,bid,连用10d;观察组加用磷酸肌酸钠1.0 g溶于0.9%氯化钠注射液100 ml,ivd,qd,连用10 d。观察两组治疗效果和安全性,比较两组患儿血清IL-6和心肌酶的变化。结果:治疗后,两组患儿肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及乳酸脱氢酶(LDH)及血清IL-6水平均较治疗前明显下降(P<0.05或P<0.01),且观察组治疗后各项指标均明显低于对照组(P<0.05)。观察组总有效率高于对照组(P<0.05);两组患儿治疗期间均未出现严重不良反应。结论:采用磷酸肌酸钠辅助治疗新生儿缺氧缺血性心肌损害疗效显著,能够有效改善患儿的心肌功能,降低心肌酶与血清IL-6水平。
Objective: To investigate the effect of creatine sodium phosphate adjunctive therapy on neonatal hypoxic-ischemic myocardial damage and serum interleukin-6 (IL-6) and myocardial enzymes. Methods: Eighty neonates with hypoxic-ischemic myocardial damage were randomly divided into observation group and control group. Both groups were to maintain ventilation, keep warm, maintain water and electrolyte and acid-base balance, maintain heart rate blood pressure, nutritional support and other conventional treatment. On the basis of this, the control group was given fructose 1,6 diphosphate 250 mg · kg-1, ivd, bid for 10 days. The observation group was treated with 1.0 g sodium phosphate phoshate and dissolved in 0.9% sodium chloride injection 100 ml, ivd, qd, once every 10 d. The therapeutic effects and safety of the two groups were observed. The changes of serum IL-6 and myocardial enzymes were compared between the two groups. Results: After treatment, the levels of creatine kinase (CK), creatine kinase CK (CK-MB), lactate dehydrogenase (LDH) and serum IL-6 in both groups were significantly lower than those before treatment (P < 0.05 or P <0.01), and the indicators in the observation group were significantly lower than those in the control group (P <0.05). The total effective rate in the observation group was higher than that in the control group (P <0.05). No serious adverse reactions occurred in the two groups during the treatment. Conclusion: The use of creatine phosphate to treat neonatal hypoxic-ischemic myocardial damage has significant curative effect, which can effectively improve the myocardial function and reduce the levels of myocardial enzymes and serum IL-6.