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目的探讨卡维地洛治疗小儿原发性心内膜弹力纤维增生症(EFE)的疗效及其对患儿血浆B型利钠肽(BNP)、心功能的影响。方法将2011年7月至2015年7月收治的86例小儿EFE患者按照治疗方法分为对照组(n=42)与观察组(n=44),两组患儿均给予洋地黄、肾上腺皮质激素、扩血管药物以及利尿剂等药物支持治疗,观察组在此基础上联合卡维地洛治疗。比较两组临床疗效、治疗前后心功能、血浆BNP水平、治疗前后生活质量评分。结果 (1)观察组患者临床治疗总有效率为93.18%,明显高于对照组的73.81%(P<0.05);(2)对照组治疗前后心胸比(C/T)水平比较差异无统计学意义(P>0.05),心率、射血分数(EF)、短轴缩短率(FS)、左心室舒张末期内径(LVEDD)及BNP水平比较差异均有统计学意义(P<0.05,P<0.01);观察组治疗前后心功能各项指标及血浆BNP水平比较差异均有统计学意义(P<0.05,P<0.01),且两组患者治疗后上述指标差异也均有统计学意(P均<0.05);(3)两组患者治疗后感情指数、健康指数及生活满意度评分均显著高于治疗前(P均<0.05),且治疗后观察组上述指标评分均显著高于对照组(P均<0.05)。结论卡维地洛治疗EFE的疗效显著,可有效降低患儿血浆BNP水平,改善心功能。
Objective To investigate the curative effect of carvedilol on children with primary endocardial fibroelastosis (EFE) and its effect on plasma B-type natriuretic peptide (BNP) and cardiac function in children. Methods Eighty-six children with EFE admitted from July 2011 to July 2015 were divided into control group (n = 42) and observation group (n = 44) according to the treatment method. Both groups were given digitalis, adrenal cortex Hormones, vasodilators and diuretics and other drug supportive treatment, the observation group on this basis combined with carvedilol treatment. The clinical efficacy, cardiac function, plasma BNP level and quality of life before and after treatment were compared between the two groups. Results (1) The total effective rate of clinical treatment in observation group was 93.18%, which was significantly higher than that in control group (73.81%, P <0.05). (2) There was no significant difference in C / T before and after treatment Heart rate, ejection fraction (EF), shortening of short axis (FS), left ventricular end-diastolic diameter (LVEDD) and BNP levels were significantly different (P <0.05, P <0.01) ). Before and after treatment, the indexes of cardiac function and plasma BNP levels in the observation group were significantly different (P <0.05, P <0.01), and the differences of the above indexes in both groups were also statistically significant (P <0.05). (3) After treatment, the scores of emotional index, health index and life satisfaction of the two groups were significantly higher than those before treatment (all P <0.05), and the scores of the above indexes in the observation group after treatment were significantly higher than those in the control group P <0.05). Conclusion Carvedilol treatment of EFE significant effect, can effectively reduce the plasma BNP levels in children, improve cardiac function.