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目的探析普罗帕酮治疗小儿川崎病合并心律失常患儿的临床效果及用药安全性。方法 100例小儿川崎病合并心律失常患儿,根据随机数字表法分为对照组和观察组,每组50例。观察组进行普罗帕酮治疗,对照组予以美托洛尔疗法,两组治疗1周,比较两组治疗前后的左心室舒张末期内径(LVED)、左心射血分数(LVEF)、C反应蛋白(CRP)、肌钙蛋白Ⅰ(CTnⅠ)等临床指标情况;比较两组治疗后的不良反应发生。结果治疗前后,观察组LVEF水平分别为(70.4±3.7)、(78.8±7.3)%,对照组LVEF水平分别为(70.5±3.6)、(72.1±5.6)%,治疗前两组LVEF水平比较差异无统计学意义(P>0.05),两组治疗后LVEF水平较治疗前均升高,且观察组LVEF水平明显高于对照组(P<0.01)。治疗前观察组LVED、CRP、CTnⅠ分别为(3.8±0.4)cm、(143.3±52.7)mg/L、(0.5±0.3)μg/L,对照组LVED、CRP、CTnI分别为(3.9±0.3)cm,(143.3±52.7)mg/L、(0.6±0.4)μg/L;治疗前两组LVED、CRP、CTnI比较差异无统计学意义(P>0.05),治疗后观察组LVED、CRP、CTnI分别为(3.1±0.1)cm、(6.9±2.6)mg/L、(0.2±0.1)μg/L,对照组LVED、CRP、CTnI分别为(3.5±0.3)cm、(14.6±3.7)mg/L、(0.5±0.3)μg/L,治疗后两组LVED、CRP、CTnI较治疗前均降低,且观察组LVED、CRP、CTnI明显低于对照组(P<0.01)。治疗期间两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论普罗帕酮治疗小儿川崎病合并心律失常患儿临床效果确切,可显著改善患儿的心功能状态,不良反应少,安全性高,值得临床推广。
Objective To investigate the clinical effect and medication safety of propafenone in children with Kawasaki disease and arrhythmia in children. Methods A total of 100 children with Kawasaki disease and arrhythmia were divided into control group and observation group according to random number table method, with 50 cases in each group. The observation group was treated with propafenone and the control group was treated with metoprolol. The two groups were treated for one week. The left ventricular end-diastolic diameter (LVED), left ventricular ejection fraction (LVEF), C-reactive protein (CRP), troponin Ⅰ (CTn Ⅰ) and other clinical indicators of the situation; compared two groups after treatment of adverse reactions. Results Before and after treatment, the levels of LVEF in the observation group were (70.4 ± 3.7) and (78.8 ± 7.3)%, respectively. The levels of LVEF in the control group were (70.5 ± 3.6) and (72.1 ± 5.6)%, There was no statistical significance (P> 0.05). The LVEF levels in both groups were significantly higher than those before treatment, and the levels of LVEF in the observation group were significantly higher than those in the control group (P <0.01). The levels of LVED, CRP and CTnⅠ in the observation group before treatment were (3.8 ± 0.4) cm and (143.3 ± 52.7) mg / L and (0.5 ± 0.3) μg / (143.3 ± 52.7) mg / L and (0.6 ± 0.4) μg / L, respectively. There was no significant difference in LVED, CRP and CTnI between the two groups before treatment (P> 0.05) (± 0.1) cm and (6.9 ± 2.6) mg / L and (0.2 ± 0.1) μg / L, respectively. The values of LVED, CRP and CTnI were (3.5 ± 0.3) cm and (14.6 ± 3.7) mg / L, (0.5 ± 0.3) μg / L respectively. The LVED, CRP and CTnI in both groups decreased after treatment, and the LVED, CRP and CTnI in the observation group were significantly lower than those in the control group (P <0.01). There was no significant difference in adverse reactions between the two groups during treatment (P> 0.05). Conclusion Propafenone in children with Kawasaki disease complicated with arrhythmia clinical effect is exact, can significantly improve children’s cardiac function status, fewer adverse reactions, high safety, worthy of clinical promotion.