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目的:探讨美托洛尔对肠道病毒71型(EV71)感染手足口病合并心肺功能障碍的治疗效果。方法:对2010年6～8月广西桂林市人民医院收治的16例EV7I感染手足口病危重症患儿的临床资料进行回顾性分析,探讨于心肺衰竭早期在综合治疗基础上应用美托洛尔对心率、血压、末梢循环及肺水肿的影响。选择既往给予综合治疗的10例EV71感染致手足口病的危重症患儿作为对照。结果:加用美托洛尔治疗的患儿的心率下降时间(2.35±1.66)h、高血压纠正时间(2.28±1.87)h、末梢循环改善时间(0.55±0.32)h及肺水肿/肺出血改善时间(23.29±11.37)h均较对照组的(10.71±3.11)h、(9.56±3.38)h、(1.86±0.41)h、(36.65±15.53)h明显缩短(均P<0.05),发生严重心律失常/心脏骤停例数显著低于对照组(P<0.05)。结论:在心肺衰竭早期应用美托洛尔能协助改善危重症手足口病患儿的心肺功能、有效阻止病情进展、改善预后。
Objective: To investigate the effect of metoprolol on enterovirus 71 (EV71) infection in hand, foot and mouth disease with cardiopulmonary dysfunction. Methods: The clinical data of 16 children with EV7I HFMD admitted to Guilin People’s Hospital from June to August 2010 were retrospectively analyzed. Metoprolol was used on the basis of comprehensive treatment in the early stage of cardiopulmonary failure Heart rate, blood pressure, peripheral circulation and pulmonary edema. Ten critically ill children with HFMD who were previously treated with combination therapy were selected as controls. Results: The heart rate decrease time (2.35 ± 1.66) h, hypertension corrected time (2.28 ± 1.87) h, peripheral circulation improvement time (0.55 ± 0.32) h and pulmonary edema / pulmonary hemorrhage in metoprolol-treated children The improvement time (23.29 ± 11.37 h) was significantly shorter than that of the control group (10.71 ± 3.11 h, (9.56 ± 3.38 h), (1.86 ± 0.41 h, (36.65 ± 15.53 h, Serious arrhythmia / cardiac arrest cases were significantly lower than the control group (P <0.05). Conclusion: The application of metoprolol in the early stage of cardiopulmonary failure can help improve the cardiopulmonary function in children with critically ill hand-foot-mouth disease, effectively prevent the progression of the disease and improve the prognosis.