RESUMO
Objective To explore the effects of L-carnitine on newborn with hypoxic ischemic myocardial injury.Methods Sixty cases with hypoxic ischemic myocardial injury were divided into two groups,including control group (n =30) receiving fructose sodium diphosphate injection,and experimental group (n =30) receiving both fructose sodium diphosphate and L-carnitine injection for 7 days.The clinical symptoms,changes of heart rates,blood pressure,volume of urine,lactic acid dehydrogenase,creatine kinase,creatine kinase-MB,cardiac troponin Ⅰ and electrocardiogram were investigated before and after treatment.Results Treatment with L-carnitine improved the symptoms of hypoxic ischemic myocardial injury,the total effective rate was 93.3％ (28/30),versus 66.7％ (20/30) in control group,the difference was statistically significant(x2 =6.667,P =0.01).Heart rates of the experimental group were significantly improved after treatment(t =-6.131,P ＜0.01),compared with the control group,there were no significant differences (P ＞ 0.05).Blood pressure and urine volume of experimental group both increased after treatment (P ＜0.05),compared with the control group,the differences were statistically significant (P ＜ 0.05).Creatine kinase and creatine kinase-MB significantly decreased after treatment,compared with the control group (P ＜ 0.05).A downward trend of cardiac troponin Ⅰ was observed in both groups,however,there was no statistically significant difference before and after treatment (P ＞ 0.05).After treatment,electrocardiogram improvement rates were no significantly different between the two groups (P ＞ 0.05).Conclusion L-camitine can contribute to protect hypoxic ischemic myocardial from further injury.
RESUMO
Objective To assess the efficacy of oral erythromycin on the functional gastrointestinal dysmotility in neonates.Methods In this double-blind,randomized,placebo controlled trial,90 neonates consecutively admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Jan 2009 to Dec 2011 were enrolled and randomly divided into low-dosage erythromycin group ( LE group,n =30 ),highdosage erythromycin group ( HE group,n =30 ) and control group ( n =30).Patients received either erythromycin ( 3 mg/kg or 10 mg/kg) or equivalent normal saline with oral or nasal feeding every 8 hours one time for 14 d.The time to achieve half,three-quarters,and full enteral nutrition,the time of parenteral nutrition,and hospital length of stay were compared among each group.Results The time to achieve half,three-quarters,and full enteral nutrition in HE group [ ( 3.0 ± 0.5 ) d,( 6.2 ± 0.7 ) d,( 8.2 ± 1.0 ) d ] and in LE group [(6.2±0.5) d,(8.3 ±0.6) d,(10.6 ±1.1) d] were shorter than that in control group [(8.1 ±0.4) d,( 13.5 ± 1.0) d,( 15.7 ± 1.2) d] ( P ＜ 0.05 ).The duration of parenteral nutrition [ ( 14.2 ± 1.4) d vs (9.3 ± 1.2) d vs (7.8 ± 1.1 ) d ] and hospital length of stay [ ( 13.0 ± 1.4 ) d vs ( 8.1 ± 0.8 ) d vs ( 6.8 ±0.7) d] were significantly prolonged in control group compared with LE and HE groups,and there were significant differences among the three groups ( P ＜ 0.05).The incidence of liver injury and septicemia during the treatment of erythromycin were similar between HE group and LE group,but it was significantly lower than control group.No serious adverse effect such as prolongation of QT intervals,dysrhythmia associated with erythromycin treatment was found.Conclusion Oral erythromycin can be considered as a treatment for neonates with functional gastrointestinal dysmotility who fail to establish adequate enteral nutrition,and highdosage oral erythromycin is more effective than low-dosage.