袁俊梅

[摘要] 目的 探讨左卡尼汀佐治小儿肺炎支原体肺炎致心肌损害的临床效果及安全性分析。 方法 将肺炎支原体肺炎并心肌损害的患儿84例随机分为治疗组及对照组各42例，对照组予以常规治疗，治疗组加用左卡尼汀口服，并比较两组疗效。 结果 两组治疗后各项心肌酶指标均下降，但治疗组优于对照组，差异有统计学意义（P＜0.05）；两组心电图恢复正常率比较差异无统计学意义（P＞0.05）。 结论 左卡尼汀佐治肺炎支原体肺炎致心肌损害疗效尚可，且安全性高。

[关键词] 左卡尼汀；肺炎支原体；肺炎；心肌损害

[中图分类号] R725.6???[文献标识码] B???[文章编号] 2095-0616（2012）15-64-02

Clinical effect of L-carnitine on 42 patients with myocardial damage caused by mycoplasma pneumoniae

YUAN?Junmei

Department of Pediatrics,the Central Hospital of Zhumadian City in Henan Province,Zhumadian 463000,China

[Abstract] Objective To explore the effect and safety of L-carnitine on myocardial damage resulting from mycoplasma pneumonia. Methods 84 cases with myocardial damage caused by mycoplasma pneumoniae were divided into treatment group and control group randomly.Each group had 42 cases.Besides conventional therapy for both groups,the treatment group was given L-earnitine. And the effect and safety were compared. Results The levels of myocardial enzyme of the control group were lower statistically after treatment,and there was significant difference between the two groups(P＜0.05).But the difference about the ECG recovery rates between the two groups was not statistically significant(P＞0.05）. Conclusion L-camitine has a better effect on the myocardial damage caused by mycoplasma pneumonia.

[Key words] L-carnitine;Mycoplasma pneumonia;Pneumonia;Myocardial damage

随着检测技术的提高，肺炎支原体（mycoplasmal pneumoniae，MP）已成为儿童社区获得性肺炎的最常见病原体之一，一般预后较好，但其严重时还可以引起肺外脏器的损害，尤其是心肌损害，庞学问[1]在534例肺炎支原体肺炎（MPP）患者发中现210例，占39.3％有肺外器官损害，累及的心血管系统患者有69例，占32.9％，甚至有同时1个或1个以上肺外器官受累，因此目前认为本病尤其是肺外心肌损害应及早诊治，笔者对MP肺炎致心肌损害的患儿加用左卡尼汀治疗，疗效尚可，现报道如下。

1?资料与方法

1.1?一般资料

选取笔者所在医院2010年1月～2011年12月住院诊断为MP感染的患儿84例，均符合MPP诊断标准[2]及MPP致心肌损害的诊断标准[3]，并排除先天性心脏病，既往心律失常、心肌炎，肝肾疾病及肌肉疾病等患儿。其中，男39例，女45例，年龄2.1～10岁，学龄前儿童66例，肌钙蛋白-I（cTnI）阳性26例，阴性58例。采用随机数字表法将所有患儿分为两组各42例，心电图异常者治疗组21例，其中ST-T改变10例，窦性心动过速7例，室性早搏3例，I度房室传导阻滞1例；……