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Objective:To investigate the clinical efficacy of creatine phosphate sodium combined with ribavirin in the treatment of infantile viral myocarditis,and to elucidate its mechanism of the effects on myocardial enzyme levels in the children.Methods:A total of 96 children with viral myocarditis were selected;according to the random number grouping method,they were divided into observation group and control group (n=48).The myocardial enzymes and cardiac troponin Ⅰ (cTnI) of the patients in two groups were detected,and anti-infection,supplementation of electrolytes,and nutritional support for myocardial treatment were performed;then intravenous infusion therapy of ribavirin was used.On this basis,the patients in observation group were given intravenous infusion of creatine phosphate sodium for 14 d.After treatment,the total effective rate of treatment of the patients in two groups,the levels of myocardial enzymes and cTnI and electrocardiogram were compared before and after treatment.Results:The total effective rate of the patients in observation group was 87.50％ (42/48),and it was 70.83％ (34/48) in control group;there was significant difference (x2 =4.04,P=0.04).After treatment,the levels of lactate dehydrogenase (LDH),hydroxybutyrate dehydrogenase (HBDH),aspartate transaminase (AST),creatine phosphokinase (CPK),creatine kinase isoenzyme-MB (CK-MB) and CTnI of the patients in two groups after treatment were lower than before treatment (P＜0.05).The indicators mentioned above of patients in observation group were lower than those in control group (P ＜0.05).The total improvement rate of electrocardiogram in the observation group (89.58％) was significantly higher than that in control group (72.92 ％),and the difference was statistically significant (x2 =4.38,P =0.04).Conclusion:The total effective rate of creatine phosphate sodium combined with ribavirin in the treatment of infantile viral myocarditis is higher,and they can significantly reduce the levels of myocardial enzymes and improve the cardiac function;it is worth to apply in the clinical treatment.
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Objective: To investigate the clinical efficacy of creatine phosphate sodium combined with ribavirin in the treatment of infantile viral myocarditis, and to elucidate its mechanism of the effects on myocardial enzyme levels in the children. Methods: A total of 96 children with viral myocarditis were selected; according to the random number grouping method, they were divided into observation group and control group (n=48). The myocardial enzymes and cardiac troponin I (cTnl) of the patients in two groups were detected, and anti-infection, supplementation of electrolytes, and nutritional support for myocardial treatment were performed; then intravenous infusion therapy of ribavirin was used. On this basis, the patients in observation group were given intravenous infusion of creatine phosphate sodium for 14 d. After treatment, the total effective rate of treatment of the patients in two groups, the levels of myocardial enzymes and cTnl and electrocardiogram were compared before and after treatment. Results: The total effective rate of the patients in observation group was 87. 50% (42/48), and it was 70. 83% (34/48) in control group; there was significant difference (X2 = 4. 04, P=0. 04). After treatment, the levels of lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), aspartate transaminase (AST), creatine phosphokinase (CPK), creatine kinase isoenzyme-MB (CK-MB) and CTnl of the patients in two groups after treatment were lower than before treatment (P<0. 05). The indicators mentioned above of patients in observation group were lower than those in control group (P < 0.05). The total improvement rate of electrocardiogram in the observation group (89.58%) was significantly higher than that in control group (72.92%), and the difference was statistically significant (X2 = 4. 38, P=0. 04). Conclusion: The total effective rate of creatine phosphate sodium combined with ribavirin in the treatment of infantile viral myocarditis is higher, and they can significantly reduce the levels of myocardial enzymes and improve the cardiac function; it is worth to apply in the clinical treatment.
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Objective To observe the effect of creatine phosphate sodium on BIS and recovery quality during general anesthesia emergence period in elderly patients.Methods Sixty ASA Ⅰ or Ⅱpatients,31 males,29 females,aged 65-80 yr undergoing transabdominal cholecystectomy by general anesthesia were randomly allocated into two groups(n=30 each):group creatine phosphate (P)and group control(C)according to random numbers generated by computer.Patients were intravenously infused with 1.0 g creatine phosphate sodium melted in 100 ml normal saline or only 100 ml normal saline in group P or C respectively in thirty minutes at the same time of surgical incision.The heart rate(HR)and bispectral index(BIS)were recorded before anesthesia induction (T0 ),during sputum aspiration (T0 ),during extubation (T2 )and 1(T3 ),5(T4 ),10(T5 ),15 minutes (T6 )after extubation. The dosage of propofol,remifentanil and cisatracurium,anesthesia duration,operation time,awake time,extubation time,recovery time of consciousness and Steward recovery scores on T3-T6 were also recorded,and the occurrence of tachycardia during the operation was observed at the same time. Results Compared with T0 ,the BIS value were lower significantly and HR were significantly in-creased on T1-T4 in the two groups(P <0.05).Compared with group C,the BIS value were signifi-cantly higher in group P on T1-T4 (P <0.05).Compared with group C,awake time,extubation time, recovery time of consciousness significantly shortened in group P (P <0.05).There were six cases of tachycardia occurring in group C which were significantly higher than two cases in group P (P <0.05).Steward recovery scores on T3 and T4 were also higher in group P (P <0.05).Conclusion Not only can 1.0 g creatine phosphate sodium administered during transabdominal cholecystectomy im-prove the BIS value of general anesthesia recovery period and recovery quality,but also effectively re-duce the incidence rate of tachycardia during operation in elderly patients.
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Objective To explore the relationship of perioperative INVOS cerebral oxygen saturation (rSO2) and postoperative cognition function alteration of geriatric patients under combined intravenous and volatile anesthesia with creatine phosphate disodium to provide guidance for clinical anesthesia. Methods Sixty ASA I-II patients aged >60 years scheduled for selective abdominal surgeries or surgeries on lower limb were enrolled in the study. The patients were randomly divided into 3 groups of 20 patients: creatine phosphate disodium group 1 (CPD1), creatine phosphate disodium group 2 (CPD2), control group (C). All the patients were not premedicated with atropine 0.5mg until entering the operation room. Anesthesia was induced with intravenous infusion of propofol, fentanyl and cisatracurium slowly, and maintained by inhalational anesthetics sevoflurane 1 MAC plus intravenous infusion of propofol (6-8mg·kg-1·min-1) and remifentanyl (0.2-0.4μg·kg-1·min-1), and intravenous bolus cisatracurium (0.07-0.10mg·kg-1). After tracheal intubation, all the patients were mechanically ventilated with PETCO2 in the normal range. rSO2 was continuously monitored and recorded during the operation. The Mini-Mental State Examination (MMSE), Trailmaking Test and Grooved Pegboard Test were used to access cognitive function 24h before surgery and 4, 8, 12, 24h after surgery. Results (1) There were no significant differences in general status between the three groups (P>0.05). (2) The scores of MMSE, Trail-making Test and Grooved Pegboard Test were not different 24h before the operation between the three groups (P>0.05). (3) The scores of cognitive tests were higher in group CPD2 and group CPD1 than in group C (P0.05). Conclusion CPD can reduce the occurrence of postoperative cognitive dysfunction in geriatric patients under combined intravenous and inhalational anesthesia.
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Objective To observe the effect and influence on plasma angiotensin Ⅱ and oxygen radicals in the treatment of children with viral myocarditis by phosphate sodium and captopril,provide reference for clinical treat-ment.Methods 80 children with viral myocarditis met the admissions criteria were randomly divided into the obser-vation group(40 cases)and the control group (40 cases),both group were received conventional therapy,which included rest,vitamin C pin,antiviral and antimicrobial agents,nutritional medicine myocardial metabolism of drugs. The control group was given captopril 0.5mg/kg,bid,the observation group was given phosphate sodium and capto-pril,phosphate sodium 0.5 -1g/d,qd,both groups had been treated for 4 weeks for a course.Plasma angiotensin Ⅱwere detected by radioimmunoassay.The EF,FS,VA /TE were detected by echocardiography instrument.The blood were collected for detecing MDA and SOD.The clinical efficacy and electrocardiogram efficacy were evaluated. Results The clinical efficacy and electrocardiogram efficacy of observation group were 95%,90%,the control group were 70%,70%,and the difference was statistically significant(χ2 =9.367,8.571,both P <0.05).The EF,FS,SOD of the observation group and the control group after treatment was significantly higher than those of before treatment (t =11.689,8.447,9.524 and 7.714,7.985,6.166,all P <0.01).The plasma angiotensin Ⅱ,VA /TE,MDA were significantly lower than those of before treatment(t =17.572,5.772,9.744 and 9.228,3.553,3.855,all P <0.05). The SOD of the observation group after treatment was significantly higher than that of the control group(t =3.932, P <0.05),VA /TE,MDA were significantly lower than that of the control group(t =3.446,3.633,10.315,all P <0.05).Conclusion The method containing phosphate sodium and captopril can collaboratively improve heart func-tion,which may be relate to the decrease in plasma angiotensin Ⅱ and scavenging oxygen free radicals.The method can significantly improve the clinical efficacy and ECG efficacy of conventional therapies,is the better treatment for promoting in the treatment of children with viral myocarditis.
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Objective To explore the protective effect of creatine phosphate sodium and compound coenzyme on tumor children with Adriamycin(ADM)-induced myocardial injury.Methods From Feb.2012 to Feb.2014,there were 153 tumor children administered in Shijitan Hospital,the Capital Medical University,among which there were 112 male and 41 female,aged from 10 months to 5 years,and the median age was 2.3 years.All the cases were randomly divided into 3 groups,with the dose of ADM at 20-30 mg/(m2 · d) for 3 days,and for 3 to 6 courses of treatment.All cases were rolled in the ADM chemotherapy:group A,intravenous infusion of creatine phosphate sodium(1.0 g/d) and compound coenzyme(1 injection/d),at a total of 7 days;group B with only intravenous infusion of creatine phosphate sodium(1.0 g/d) for a total of 7 days;group C with only intravenous infusion compound coenzyme(1 injection/d) for a total of 7 days.Two days before ADM chemotherapy,creatine phosphate sodium and / or compound coenzyme were administrated to protect the musculus cardiacus.One day before chemotherapy and two days after chemotherapy,the peripheral blood was taken to determine levels of malondialdehyde (MDA),creatine kinase (CK),creatine kinase MB (CK-MB),cardiac troponin(cTnT),N terminal pro-brain natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hsCRP),electrocardiogram,echocardiogram and so on.Then the changes of all those indicators before and after the chemotherapy between the groups were compared.Results The morbidity of myocardial damage induced by ADM was increased significantly with its dose accumulation (x2 =18.462,P ＜ 0.05).Creatine phosphate sodium combined with compound coenzyme could decrease the morbidity of myocardial damage induced by ADM (x2 =4.883,5.971,all P ＜ 0.05).Compared with those before chemotherapy,the cTnT (t =2.561,P ＜ 0.05),NT-proBNP (t =6.654,P ＜ 0.01) and hsCRP(t =3.149,P ＜ 0.01) levels of group A decreased markedly.Serum levels of MDA (t =2.170,P ＜0.05),CK-MB(t =2.596,P ＜0.05) and hsCRP(t =2.604,P ＜0.05) of group B increased obviously.Serum levels of MDA (t =2.151,P ＜ 0.05) and CK-MB (t =4.109,P ＜ 0.05) of group C also increased obviously.After chemotherapy,the detection of serum indexes of all groups showed as below.Contracted with those of group A,the serum MDA(t =4.461,P ＜ 0.01),CK-MB (t =3.273,P ＜ 0.01),cTnT (t =3.476,P ＜ 0.01),NT-proBNP (t =7.081,P ＜ 0.01) and hsCRP(t =5.941,P ＜ 0.01) levels of group B increased distinctly.Meanwhile,the MDA (t =4.064,P ＜0.01),CK-MB(t =5.452,P ＜0.01),cTnT(t =2.768,P ＜0.05),NT-proBNP(t =4.806,P ＜0.01)and hsCRP(t =3.436,P ＜ 0.05) levels of group C also increased significantly.Conclusions Both creatine phosphate and compound coenzyme could reduce the myocardial damage induced by ADM.Combination of them has important clinical value for better prevention of cardiac toxicity of ADM,enhancement of the prognosis of childhood tumor,and improvement of the long-term quality life of those children.
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Objective To observe the effects of creatine phosphate sodium on heart function and B -type natriuretic peptide in patients combination with ischemic cardiomyopathy and intractable heart failure .Methods 70 cases of coronary heart disease combined with ischemic cardiomyopathy and intractable heart failure were randomly ( with the random number table ) divided into the control group ( n=33) and the creatine phosphate sodium treatment group (n=37).The control group treated with conventional therapy (digitalis,diuretics,vasodilator,ACEI,et al) ten days;the treatment group with creatine phosphate sodium treatment on the basis of conventional therapy .The symp-tom,sign of the heart failure patients of the two groups before and after treatment were observed .NYHA cardiac func-tional grading were estimated.Echocardiography was used to detect left ventricular end -systolic diameter(LVESD), left ventricular end diastolic diameter ( LVEDD ) and left ventricular ejection fraction ( LVEF ); amino terminal pro brain natriuretic peptide (NT-proBNP) tested by laboratory of the two groups.Drug treatment for 10 days,the chan-ges of the indicators before and after treatment were observed .Results After treatment , compared with the control group[(50.63 ±4.67) mm,(61.30 ±4.58) mm].LVESD,LVEDD of the creatine phosphate sodium treatment [(47.16 ±4.30)mm,(57.92 ±4.30)mm]significantly decreased(t=5.73,4.96,all P<0.01),LVEF[(40.57 ± 4.51)%,(37.63 ±4.53)%]increased significantly(t =5.53,P<0.01).After ten days of treatment levels of NT-proBNP decreased in both two groups [(1 659.±248.18) pg/mL,1 899.3 ±205.45] than before treatment [2 043.46 ±217.04,(2 105.46 ±239.09)pg/mL](t=3.23,3.64,all P<0.05),and the decrease degree of the creatine phosphate sodium treatment group was more obvious than those of the control group (t=4.11,P<0.05). Conclusion Creatine phosphate sodium can improve the cardiac function and left ventricular ejection fraction of ischemic cardiomyopathy and intractable heart failurepatients ,enhance the clinical symptoms of patients .
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Objective This study is to investigate the protective effect of creatine phosphate so-dium on circulatory function in unilateral total knee replacement surgery using bone cement implanta-tion.Methods Forty patients undergoing unilateral total knee replacement surgery with bone cement were randomly assigned into 2 groups:test group (group CP,n=20)and control group (group NS, n=20).The easophageal doppler ultrasound probe was placed at the level of the third rib transorally after induction in each patient.In group CP,creatine phosphate sodium (2 g in 100 ml normal saline) was infused (within 30 min)at 30 min before the operation,as well as normal saline 100 ml in group NS.SBP,DBP,HR,SpO2 ,PET CO2 and BIS were monitored and recorded before (T0 )and 1 (T1 ),3 (T2 ),5 (T3 ),10 (T4 )min after insertion of bone cement.Cardiac output (CO),stroke volume (SV)and left ventricular end-diastolic volume (LVEDV)were simultaneously monitored and recorded with esophageal doppler ultrasound.WhileⅡ-lead electrocardiogram were recorded to monitor ven-tricular arrhythmia perioperatively.Results SBP,DBP and HR decreased at T2 and T3 in group NS, and were lower than those in group CP (P <0.05 );Meanwhile,compared with group CP,CO and SV were significantly lower,while LVEDV was significantly higher in group NS (P <0.05 ).Com-pared with T0 ,CO and SV decreased and LVEDV increased at T2 and T3 in group NS (P <0.05 ). After insertion of bone cement,the incidence of arrhythmia in group CP was obviously lower than that in group NS (P < 0.05 ).Conclusion Pretreatment with creatine phosphate sodium can effectively prevent the incidence of bone cement implantation syndrome (BCIS)by stabilizing hemodynamic in elderly patients undergoing total knee replacement with bone cement.
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Objective To investigate the effect of creatine phosphate sodium on postoperative fatigue syndrome (POFS) in gastric carcinoma patients. Methods Nighty cases of radical resection in gastric cancer were randomly divided into control group (n=45) and treatment group (n=45).Normal saline (100 mL) and phosphocreatine sodium (2 g) was admin-istrated intravenously after anaesthesia induction in treatment group while only normal saline was given in control group . After operation, the two groups of patients were all treated with enteral and parenteral nutrition. General performance was ob-served in both groups. Fatigue score (VAS score) was measured on the day before the operation,the first,third and fifth day after operation. Body weight, triceps skinfold thickness (TSF), mid upper arm circumference (AMC), plasma total protein (TP), plasma albumin (ALB) and prealbumin (PA) were examined at the same time. Results The total effective rate of the control group and the study group were 73.3%and 95.6%respectively and the difference was of statistically significant. Fa-tigue scores (VAS score) was significantly difference in both groups pre- and post-operation time points, also between 2 groups. Body mass, TSF and AMC in time points postoperation were all lower than those in the time point of preoperation. TP, ALB and PA of two groups in postoperative time points were significantly different compared with those in preoperative time point. The above indexes were all decreased with postoperation time, and these indexes in treatment group were signifi-cantly better than those in control group. Conclusion Creatine phosphate sodium can alleviate postoperative fatigue, im-prove nutritious status and promote early rehabilitation of patients.