目的 探討榮心丸聯(lián)合環(huán)磷腺苷治療兒童急性病毒性心肌炎臨床療效。方法 選擇2019年7月—2020年7月在鄭州大學(xué)附屬兒童醫(yī)院治療的98例急性病毒性心肌炎患兒，根據(jù)就診順序分成對照組（49例）和治療組（49例）。對照組靜脈滴注注射用環(huán)磷腺苷，1 mg/kg加入100 mL生理鹽水，1次/d。治療組在對照組的基礎(chǔ)上口服榮心丸，1～3歲患兒3 g/次，3～6歲4.5 g/次，6歲以上6 g/次，3次/d。兩組患兒治療2周。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時(shí)間，血清C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-18（IL-18）、降鈣素原（PCT）、人巨噬細(xì)胞移動抑制因子（MIF）、人心型脂肪酸結(jié)合蛋白（H-FABP）、心肌肌鈣蛋白（cTnI）、肌酸激酶（CK）、磷酸肌酸激酶同工酶（CKMB）、乳酸脫氫酶（LDH）水平，及心功能指標(biāo)左室射血分?jǐn)?shù)（LVEF）、每搏輸出量（SV）、心排血量（CO）。結(jié)果 經(jīng)治療，對照組總有效率為81.63%，顯著低于治療組的97.96%（P<0.05）。治療組患兒臨床癥狀改善時(shí)間均明顯早于對照組（P<0.05）。經(jīng)治療，兩組患兒血清hs-CRP、IL-18、PCT、MIF、H-FABP、cTnI、CK、CK-MB和LDH水平均顯著下降（P<0.05），且治療組降低最顯著（P<0.05）。經(jīng)治療，兩組患兒LVEF、SV、CO均明顯升高（P<0.05），且治療組患兒心功能明顯好于對照組（P<0.05）。結(jié)論 榮心丸聯(lián)合注射用環(huán)磷腺苷治療急性病毒性心肌炎患兒可有效改善臨床癥候及心功能，降低血清炎癥因子水平，進(jìn)而減輕心肌損傷，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Rongxin Pills combined with adenosine cyclophosphate in treatment of children with acute viral myocarditis. Methods Children (98 cases) with acute viral myocarditis in Children’s Hospital Affiliated to Zhengzhou University from July 2019 to July 2020 were divided into control (49 cases) and treatment (49 cases) groups based on visiting order. Children in the control group were iv administered with Adenosine Cyclophosphate for injection, 1 mg/kg added into 100 mL normal saline, once daily. Children in the treatment group were po administered with Rongxin Pills on the basis of the control group, 3 g/time for 1 — 3 years old, 4.5 g/time for 3 — 6 years old, 6 g/time for more than 6 years old, three times daily. Children in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the improvement time of clinical symptoms, and the serum levels of hs-CRP, IL-18, PCT, MIF, H-FABP, cTnI, CK, CK-MB and LDH, and the cardiac function indexes of LVEF, SV and CO in two groups before and after treatment were compared. Results After treatment, the effective rate in the control group was 81.63%, which was significantly lower than 97.96% in the treatment group (P<0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the serum levels of hs-CRP, IL-18, PCT, MIF, H-FABP, cTnI, CK, CK-MB and LDH were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05). After treatment, LVEF, SV, and CO were significantly increased in two groups, and the cardiac function in the treatment group was significantly better than that in the control group (P<0.05). Conclusion Rongxin Pills combined with adenosine cyclophosphate in treatment of children with acute viral myocarditis can effectively improve the clinical symptoms and cardiac function, reduce the level of serum inflammatory factors, and then reduce myocardial injury, which has a certain clinical application value.

R985

河南省醫(yī)學(xué)科技攻關(guān)項(xiàng)目（2018020617）