本文關(guān)鍵詞：果糖二磷酸鈉聯(lián)合大劑量Vc輔助治療兒童支原體肺炎心肌損害的觀察　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的在常規(guī)治療的基礎(chǔ)上,使用大劑量維生素C聯(lián)合果糖二磷酸鈉以消除氧自由基、增加冠狀動(dòng)脈血流量、改善心肌代謝、增強(qiáng)心肌收縮力、抑制氧自由基和組織胺釋放、增加紅細(xì)胞內(nèi)二磷酸甘油酸的含量,從而營養(yǎng)心肌輔助治療支原體肺炎伴心肌損害,通過比較心肌酶譜、心電圖、心肌肌鈣蛋白、胸部X片等臨床指標(biāo),觀察在治療兒童支原體肺炎伴有心肌損害時(shí)聯(lián)合治療是否優(yōu)于常規(guī)臨床營養(yǎng)治療。方法選取在我院兒內(nèi)科住院治療的自2015年6至2016年5月診斷為“肺炎支原體合并心肌損害”的患兒,隨機(jī)分成2組,觀察組50例,對(duì)照組50例,共100例。2組資料分布一致,沒有顯著性差異,2組均給予阿奇霉素抗感染,同時(shí)給予果糖二磷酸鈉、輔酶Q10營養(yǎng)心肌,觀察組又在此基礎(chǔ)上加用大劑量維生素C營養(yǎng)心肌,療程均為14天,觀察2組患兒的臨床癥狀緩解狀況并檢測心肌酶譜、心電圖、心肌肌鈣蛋白、外周血象白細(xì)胞計(jì)數(shù)、超敏C反應(yīng)蛋白、胸片治療前后的變化情況。對(duì)比兩組臨床患兒的治療效果。實(shí)驗(yàn)結(jié)果采用SPSS 22軟件包進(jìn)行統(tǒng)計(jì)學(xué)分析,計(jì)數(shù)資料以率(%)表示,組間比較采用X2檢驗(yàn),計(jì)量資料以(?)±s表示,采用方差分析,兩組間比較采用t檢驗(yàn),有效率比較采用Ridit分析,以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果觀察組患兒治療后臨床表現(xiàn)及大部分輔助檢查均較對(duì)照組有明顯改善(P0.05),觀察組治愈例數(shù)明顯較對(duì)照組多(P0.05);兩組心肌酶譜比治療前明顯下降,且觀察組下降程度明顯大于對(duì)照組(P0.05);心電圖恢復(fù)時(shí)間觀察組較對(duì)照組縮短(P0.05),肌鈣蛋白I陰轉(zhuǎn)率觀察組高于對(duì)照組(P0.05);治療后白細(xì)胞計(jì)數(shù)差值在兩組間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),治療后超敏C反應(yīng)蛋白下降明顯,觀察組下降程度明顯大于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),胸部X片觀察,兩組患兒治療后比治療前均明顯好轉(zhuǎn),但兩組間比較治愈率、總有效率差異無統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者的臨床治愈率(72%),優(yōu)于對(duì)照組(42%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論果糖二磷酸鈉聯(lián)合大劑量維生素C輔助治療兒童支原體肺炎心肌損害臨床效果顯著,優(yōu)于常規(guī)的營養(yǎng)心肌治療,比單用果糖二磷酸鈉治療效果明顯。大劑量維生素C配合果糖二磷酸鈉能夠起協(xié)同作用,對(duì)支原體肺炎心肌損害具有良好的改善功能。該試驗(yàn)進(jìn)一步證明果糖二磷酸鈉注射液聯(lián)合大劑量維生素C靜脈用藥可用以輔助治療支原體肺炎心肌損害,臨床效果顯著,而且患者經(jīng)濟(jì)負(fù)擔(dān)小,更適合在基層醫(yī)院推廣使用。
[Abstract]:Objective to eliminate oxygen free radicals, increase coronary blood flow, improve myocardial metabolism and enhance myocardial contractility by using high dose vitamin C combined with fructose diphosphate on the basis of routine therapy. Inhibit the release of oxygen free radicals and histamine, increase the content of glyceric acid diphosphate in erythrocytes, thereby nutritional myocardial treatment of mycoplasma pneumonia with myocardial damage, by comparing myocardial enzyme spectrum, electrocardiogram, cardiac troponin. Chest X ray and other clinical indexes. To observe whether the combined therapy in the treatment of mycoplasma pneumonia with myocardial damage in children is superior to the routine clinical nutritional therapy. Mycoplasma pneumoniae with myocardial damage "in children. They were randomly divided into two groups: the observation group (n = 50) and the control group (n = 50). The distribution of the data in group 2 was consistent, and azithromycin and sodium fructose diphosphate were given to both groups without significant difference. CoQ10 nutritious myocardium, observation group on this basis and high dose of vitamin C nutrition myocardium, the course of treatment is 14 days, observe the two groups of children's clinical symptoms relief and detection of myocardial enzyme spectrum, electrocardiogram. Cardiac troponin, peripheral blood leukocyte count, hypersensitive C-reactive protein. The changes of chest radiographs before and after treatment were compared between the two groups. The results of the experiment were analyzed statistically by SPSS 22 software package, and the counting data were expressed as rate. X2 test was used to measure the data. Analysis of variance (ANOVA), t test and Ridit analysis were used to compare the efficiency of the two groups. Results after treatment, the clinical manifestations and most auxiliary examinations in the observation group were significantly improved than those in the control group (P0.05). The number of cases cured in the observation group was significantly higher than that in the control group (P 0.05). The myocardial enzyme spectrum of the two groups was significantly lower than that of the control group before treatment, and the degree of the decrease in the observation group was significantly higher than that in the control group (P 0.05). The recovery time of ECG in the observation group was shorter than that in the control group (P 0.05), and the positive rate of troponin I in the observation group was higher than that in the control group. After treatment, there was no significant difference in white blood cell count difference between the two groups. After treatment, the hypersensitive C-reactive protein decreased significantly, and the degree of decrease in the observation group was significantly higher than that in the control group. The difference was statistically significant (P 0.05), chest X ray observation showed that the two groups were better than before, but the cure rate was higher between the two groups. There was no significant difference in the total effective rate (P 0.05). The clinical cure rate of the observation group was 72%, which was better than that of the control group (42%). Conclusion the clinical effect of fructose diphosphate combined with high dose vitamin C in the treatment of mycoplasma pneumonia in children with myocardial damage is significant and superior to the routine nutritional myocardial therapy. Compared with fructose diphosphate alone, high dose of vitamin C and sodium fructose diphosphate can play a synergistic effect. It is further proved that fructose sodium diphosphate injection combined with high dose vitamin C intravenous administration can be used to assist the treatment of mycoplasma pneumonia myocardial damage. The clinical effect is remarkable, and the patient's economic burden is small, which is more suitable for popularizing and using in the basic level hospital.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R725.6

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