大剂量维生素C联合果糖二磷酸钠治疗新生儿窒息后心肌损伤的效果及对心肌酶谱的影响
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摘要
目的探究大剂量维生素C联合果糖二磷酸钠治疗新生儿窒息后心肌损伤的效果及对心肌酶谱的影响。方法将2017年11月至2018年11月本院收治的50例窒息后心肌损伤新生儿作为研究对象,按照抽签法将患儿分为对照组(25例)与观察组(25例)。两组患儿均接受窒息后心肌损伤常规治疗,在此基础上,对照组患儿给予大剂量维生素C治疗,观察组给予大剂量维生素C+果糖二磷酸钠治疗。比较两组患儿的临床疗效、治疗前、后的氧化应激指标、心肌酶谱指标水平、LVEF、临床症状消失时间、心电图改善时间及不良反应发生情况。结果观察组患儿的治疗总有效率为96.00%,显著高于对照组的76.00%(P<0.05);治疗后,两组患儿的MDA、AOPP水平均降低,SOD水平均升高,观察组患儿的MDA、SOD、AOPP水平均优于对照组(P<0.05);治疗后,两组患儿的CK、LDH、CK-MB、AST、α-HBDH、cTnI、NT-proBNP水平均降低,且观察组低于对照组(P<0.05);治疗后,两组患儿的LVEF均升高,观察组患儿的LVEF高于对照组,临床症状消失时间、心电图改善时间均短于对照组,差异具有统计学意义(P<0.05);观察组患儿不良反应总发生率显著低于对照组(P<0.05)。结论大剂量维生素C联合果糖二磷酸钠治疗新生儿窒息后心肌损伤的效果理想。
Objective To explore the effect of high-dose vitamin C combined with fructose diphosphate sodium on myocardial injury after neonatal asphyxia and its effect on myocardial enzymogram. Methods From November 2017 to November 2018, 50 neonatus with myocardial injury after asphyxia were divided into control group(25 cases) and observation group(25 cases) by drawing lots method. Both groups received routine treatment for myocardial injury after asphyxia, on this basis, the control group was treated with high-dose vitamin C, while the observation group was treated with high-dose vitamin C+fructose diphosphate sodium. The clinical efficacy, levels of oxidative stress indexes, myocardial enzymogram indexes, LVEF before and after treatment, disappearance time of clinical symptoms, improvement time of electrocardiogram and incidences of adverse reactions between the two groups were compared. Results The total effective rate of treatment in the observation group was 96.00%, which was significantly higher than 76.00% in the control group(P<0.05). After treatment, the levels of MDA and AOPP in the two groups decreased, while the SOD levels increased, the levels of MDA, SOD and AOPP in the observation group were better than those in the control group(P <0.05). After treatment, the levels of CK, LDH, CK-MB, AST, α-HBDH, cTnI and NT-proBNP in the two groups decreased, and those in the observation group were lower than the control group(P<0.05). After treatment, the LVEF of the two groups increased,and the LVEF of the observation group was higher than that of the control group, and the disappearance time of clinical symptoms and the improvement time of electrocardiogram were shorter than those of the control group, the differences were statistically significant(P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05). Conclusion The high-dose vitamin C combined with fructose diphosphate sodium on myocardial injury after neonatal asphyxia has idea leffect.
Objective To explore the effect of high-dose vitamin C combined with fructose diphosphate sodium on myocardial injury after neonatal asphyxia and its effect on myocardial enzymogram. Methods From November 2017 to November 2018, 50 neonatus with myocardial injury after asphyxia were divided into control group(25 cases) and observation group(25 cases) by drawing lots method. Both groups received routine treatment for myocardial injury after asphyxia, on this basis, the control group was treated with high-dose vitamin C, while the observation group was treated with high-dose vitamin C+fructose diphosphate sodium. The clinical efficacy, levels of oxidative stress indexes, myocardial enzymogram indexes, LVEF before and after treatment, disappearance time of clinical symptoms, improvement time of electrocardiogram and incidences of adverse reactions between the two groups were compared. Results The total effective rate of treatment in the observation group was 96.00%, which was significantly higher than 76.00% in the control group(P<0.05). After treatment, the levels of MDA and AOPP in the two groups decreased, while the SOD levels increased, the levels of MDA, SOD and AOPP in the observation group were better than those in the control group(P <0.05). After treatment, the levels of CK, LDH, CK-MB, AST, α-HBDH, cTnI and NT-proBNP in the two groups decreased, and those in the observation group were lower than the control group(P<0.05). After treatment, the LVEF of the two groups increased,and the LVEF of the observation group was higher than that of the control group, and the disappearance time of clinical symptoms and the improvement time of electrocardiogram were shorter than those of the control group, the differences were statistically significant(P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05). Conclusion The high-dose vitamin C combined with fructose diphosphate sodium on myocardial injury after neonatal asphyxia has idea leffect.
引文
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[5]许霞,王富军,鄢家苗.环磷腺苷葡胺、大剂量维生素C联合丹参注射液治疗新生儿窒息后心肌损伤的疗效及对相关指标的影响[J].现代中西医结合杂志,2017,26(32):3589-3591.
[6]孙畅,付秀娟,王鑫璐,等.磷酸肌酸钠治疗新生儿窒息后心肌损伤疗效的Meta分析[J].中国妇幼保健,2016,31(22):4902-4907.
[7]姬静璐,王玉.磷酸肌酸钠治疗新生儿窒息后心肌损伤的临床效果观察[J].中国处方药,2015,13(5):93-94.
[8]王永辉.乌司他丁联合磷酸肌酸钠对新生儿窒息后心肌损伤的影响[J].现代临床医学,2018,44(1):51-52,55.
[9]孔凡玲,胡绍举,刘宽,等.新生儿窒息后对心肌损伤标志物的影响以及磷酸肌酸钠的干预效果分析[J].广东医学,2018,39(9):1398-1401.
[2]邓香,董文斌.血清CK-MB、c TnT水平对新生儿窒息后心肌损伤及治疗效果的预测价值[J].重庆医学,2017,46(31):4416-4418.
[3]周丽萍.新生儿窒息后心肌损伤治疗中二磷酸果糖与维生素C的应用效果分析[J].中国社区医师,2016,32(33):67,69.
[4]赵华,黄光菊.磷酸肌酸钠注射液治疗新生儿窒息后心肌损伤的效果研究[J].医学信息,2018,31(1):136-137.
[5]许霞,王富军,鄢家苗.环磷腺苷葡胺、大剂量维生素C联合丹参注射液治疗新生儿窒息后心肌损伤的疗效及对相关指标的影响[J].现代中西医结合杂志,2017,26(32):3589-3591.
[6]孙畅,付秀娟,王鑫璐,等.磷酸肌酸钠治疗新生儿窒息后心肌损伤疗效的Meta分析[J].中国妇幼保健,2016,31(22):4902-4907.
[7]姬静璐,王玉.磷酸肌酸钠治疗新生儿窒息后心肌损伤的临床效果观察[J].中国处方药,2015,13(5):93-94.
[8]王永辉.乌司他丁联合磷酸肌酸钠对新生儿窒息后心肌损伤的影响[J].现代临床医学,2018,44(1):51-52,55.
[9]孔凡玲,胡绍举,刘宽,等.新生儿窒息后对心肌损伤标志物的影响以及磷酸肌酸钠的干预效果分析[J].广东医学,2018,39(9):1398-1401.