磷酸肌酸钠治疗新生儿窒息后心肌损害临床疗效研究

目的 观察磷酸肌酸钠对新生儿窒息后心肌损害的心肌酶谱、肌钙蛋白（cTnI）、心电图（ECG）的影响以及临床治疗效果.方法 选取成都市新都区妇幼保健院新生儿科84例新生儿窒息后心肌损害患儿按随机数字表分为观察组42例和对照组42例,对照组采用常规方法治疗,观察组在对照组的基础上行静脉点滴磷酸肌酸钠0.5g/次,1次/d,两组均治疗7d.观察治疗前后患儿症状、体征改善情况,检测心肌酶谱、肌钙蛋白水平,进行ECG监测,评价两组临床疗效.结果 观察组和对照组总有效率分别为90.48%、66.67%（χ2=7.071,P＜0.05）,ECG异常率分别为30.95%（13/42）、73.81%（31/42）,（χ2=15.464,P＜0.05）.观察组和对照组治疗后AST、CK、CK-MB、LDH、cTnI均较治疗前降低,LVEF较治疗前明显升高,差异均有统计学意义（P＜0.05）.结论 磷酸肌酸钠能够使心肌酶谱尽快地恢复正常,保护心肌,改善心功能,提高临床疗效,值得临床推广使用.

Clinical Effect of Sodium Phosphocreatine Treatment for Myocardial Damage after Neonatal asphyxia

Objective To observe the influence of myocardial enzymes, troponin, ECG in the treatment of neonatal with myocardial damage after asphyxia by phosphate sodium, to optimize clinical outcomes.. Methods 84 neonatal with myo- cardiaJ damage after asphyxia were randomly divided into observation group and control group, 42 case of each group, Control group were given conventional treatment, observation group were given phosphate sodium on base on control group, O. 5g/time, qd, both group had been treated for 7d, observed symptoms and signs, detected myocardial enzymes and troponin, monitored electrocardiogram, evaluated clinical efficacy before and after treatment. Results the total effective rate of observation group and control group were 90. 48% vs 66. 67% （ P 〈 0. 05 ）, the ECG abnormalities of observation group and control group were 30.95% vs 73. 81% （P 〈 0. 05）. AST, CK, CK - MB, LDH, cTnI of observation group and control group after treatment all was significantly lower than before treatment, LVEF was significantly higher than before treatment, and each index of the obser- vation group after treatment were better than the control group （ P 〈 0. 05 ）. Conclusion Phosphate sodium can make myocar- dial enzymes returned to normal, protect the myocardium, improve cardiac function, reduce abnormal ECG rate and improve effect of clinical and ECG, and the security is good, is worthy of clinical use.