作者：杨士斌，唐晓娜，杨秀献，张莲，王盼，陈源

单位：

1.050000河北省石家庄市，河北医科大学第二医院儿科 2.050000河北省石家庄市，河北省儿童医院神经内二科 3.054300河北省邢台市，临城县医院儿科 4.073000河北省保定市，定州市人民医院儿科 通信作者：陈源，E-mail：lfus9r@163.com

Units：

1.Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China 2.Department of Neurology, Children's Hospital of Hebei Province, Shijiazhuang 050000, China 3.Department of Pediatrics, Lincheng County Hospital, Xingtai 054300, China 4.Department of Pediatrics, Dingzhou City People's Hospital, Baoding 073000, China Corresponding author: CHEN Yuan, E-mail: lfus9r@163.com

关键词：

心力衰竭; 左卡尼汀; 机械通气; 炎症反应; 心功能; 治疗结果;

Keywords：

Heart failure; L-carnitine; Mechanical ventilation; Inflammatory response; Cardiac function; Treatment outcome

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.134

Funds：

河北省卫生健康委员会资助项目（20200911）

摘要：

目的 探讨左卡尼汀辅助机械通气对心力衰竭患儿炎症反应及心功能的影响。方法 选取2018年1月至2020年1月于河北医科大学第二医院治疗的心力衰竭患儿90例作为研究对象,采用随机数字表法将其分为对照组与研究组,每组45例。对照组采用常规治疗与机械通气,研究组在对照组基础上增加左卡尼汀治疗,比较两组患儿临床疗效,治疗前及治疗3、7 d后血清指标[脑钠肽(BNP)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)]水平,治疗前及治疗7 d后心功能指标[心率(HR)、左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)及左心室舒张末期内径(LVEDD)]以及撤机成功率。结果 研究组患儿临床疗效优于对照组(P<0.05)。治疗方法与时间在血清BNP、TNF-α、IL-6水平上不存在交互作用(P>0.05);时间、治疗方法在血清BNP、TNF-α、IL-6水平上主效应显著(P<0.05)。两组患儿治疗3、7 d后血清BNP、TNF-α、IL-6水平分别低于本组治疗前,治疗7 d后血清BNP、TNF-α、IL-6水平分别低于本组治疗3 d后(P<0.05)。治疗3、7 d后,研究组患儿血清BNP、TNF-α、IL-6水平低于对照组(P<0.05)。治疗7 d后,两组患儿HR、LVESD、LVEDD分别低于本组治疗前,LVEF分别高于本组治疗前,且研究组HR、LVESD、LVEDD低于对照组,LVEF高于对照组(P<0.05)。研究组患儿撤机成功率高于对照组(P<0.05)。结论左卡尼汀辅助机械通气可有效提高心力衰竭患儿临床疗效及撤机成功率,减轻炎症反应,改善心功能。

Abstract：

【Abstract】　Objective To analyze the effects of L-carnitine assisted mechanical ventilation on inflammatory responseand cardiac function in children with heart failure. Methods A total of 90 children with heart failure treated in the SecondHospital of Hebei Medical University from January 2018 to January 2020 were selected as the research objects. The children weredivided into control group and study group by random table number method, with 45 cases in each group. The control group receivedconventional treatment and mechanical ventilation, and the study group received L-carnitine treatment on the basis of the controlgroup. The clinical efficacy, serum index levels [brain natriuretic peptide (BNP) , tumor necrosis factor-α(TNF-α) , interleukin 6(IL-6) ] before treatment and at 3, 7 days after treatment, cardiac function indexes [heart rate (HR) , left ventricular ejection fraction(LVEF) , left ventricular end-systolic diameter (LVESD) , left ventricular end-diastolic diameter (LVEDD) ] before treatment and at7 days after treatment and weaning success rate were compared between the two groups. Results The clinical efficacy of the studygroup was better than that of the control group (P <0.05) . There was no interaction between treatment method and time on serumBNP, TNF-α, and IL-6 levels (P >0.05) ; the main effects of time and treatment method on serum BNP, TNF-α and IL-6 levelswere all significant (P <0.05) . The levels of serum BNP, TNF-α and IL-6 at 3 and 7 days after treatment in the two groups werelower than those before treatment, and the levels of serum BNP, TNF-α and IL-6 at 7 days after treatment were lower than thoseat 3 days after treatment, respectively (P <0.05) . The serum BNP, TNF-α and IL-6 levels in the study group were lower thanthose in the control group at 3 and 7 days after treatment (P <0.05) . At 7 days after treatment, the HR, LVESD, and LVEDD of thetwo groups were lower than those before treatment, and the LVEF was higher than that before treatment, respectively, and the HR,LVESD, and LVEDD of the study group were lower than those of the control group, and the LVEF was higher than that of the controlgroup (P <0.05) . The success rate of weaning in the study group was higher than that in the control group (P <0.05) . ConclusionL-carnitine-assisted mechanical ventilation therapy can effectively improve the clinical efficacy and success rate of weaning ofchildren with heart failure, reduce the inflammatory response, improve the cardiac function.

ReferenceList：