中西结合治疗对不同年龄段手足口病患儿心肌酶的影响

目的:对2组不同年龄段手足口病患儿进行中西医结合治疗,分析治疗前后心肌酶恢复情况。方法:对住院治疗的手足口病患儿随机抽样92例,按年龄分为A组(年龄小于3岁)和B组(年龄3岁及以上),2组患儿均予利巴韦林,喜炎平或炎琥宁、痰热清等及水溶性维生素辅助治疗;检测治疗前后心肌酶:肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH)、a-羟丁酸脱氢酶(HBDH)恢复情况。结果:2组患儿治疗后CK、LDH、HBDH 3项心肌酶均明显降低,与治疗前比较差异有统计学意义(P0.05),而CK-MB治疗前后无明显降低(P0.05);A组平均治愈出院时间和平均退热时间与B组对比,差异无统计学意义(P0.05),2组临床疗效相当。结论:该治疗方案治疗不同年龄患儿手足口病疗效相近,心肌酶恢复情况近似;CK-MB对心肌病变有一定的特异性和时限性,早期检测CK-MB对判断手足口病的心肌损害意义较大。

Influence of Integrative Medicine on Myocardial Enzymes of the Children with Hand-foot-and-mouth Disease at Different Ages

Objective: To analyze myocardial enzymes recovery conditions before and after treating by treating the children with hand-foot-and-mouth disease at different ages by integrative medicine in both groups. Methods: All 92 children were randomly chosen, divided into A group (younger than three years) and B group (older than three years), both groups were treated by Chinese patent drugs including ribavirin, XiYanPing or potassium sodium dehydroandroan drographolide succinate for injection, TanReQing and hydrosoluble vitamin as adjunctive therapy; myocardial enzymes including creatine kinase (CK), CKMB, lactic dehydrogenase (LDH) and α- hydroxybutyric dehydrogenase (HBDH) were detected before and after treating, to explore the rules of myocardial enzymes in different ages. Results: CK, LDH and HBDH decreased obviously in both groups after treating, the difference showed statistical meaning when they were compared with before treating, while CK-MB presented no remarkable decrease between before and after treating (P>0.05); the difference had no statistical meaning when A was compared with B in average healing and discharging time, average antipyretic time (P>0.05), both groups were equivalent to clinical effects. Conclusion: Curative effects of therapeutic regimens in treating the children with hand-foot-and-mouth disease at different ages are close, the conditions of myocardial enzymes recovery are similar to each other; CKMB demonstrates certain specificity and time limit to cardiomyopathy, early detection of CKMB is meaningful to judge myocardial damage of hand-foot-and-mouth disease.