摘要
【目的】探讨乌司他丁联合环磷腺苷葡胺治疗病毒性心肌炎(VMC)的临床疗效及对相关凋亡分子的影响。【方法】选取本院收治的106例VMC患者,根据随机数表法将其分为观察组(乌司他丁联合环磷腺苷葡胺治疗)和对照组(环磷腺苷葡胺治疗),每组各53例。两组患者均治疗2周,比较两组患者临床疗效、心肌损伤指标[心肌肌钙蛋白I(cTnI)、肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)]、凋亡分子[可溶性细胞凋亡因子(sFas)、可溶性凋亡相关因子配体(sFasL)]水平及不良反应发生情况。【结果】治疗2周后,观察组临床疗效总有效率为92.45%(49/53),显著高于对照组的75.47%(40/53),差异有统计学意义(χ^(2)=5.68,P=0.017<0.05)。治疗2周后,两组患者血清cTnI、CK、CK-MB、sFas、sFasL水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率为11.32%(6/53),高于对照组的5.66%(3/53),但差异无统计学意义(χ^(2)=0.49,P=0.48>0.05)。【结论】乌司他丁联合环磷腺苷葡胺治疗VMC患者的临床疗效较好,可有效减轻患者心肌损伤,这可能与其抑制凋亡分子有关,且加用乌司他丁未明显增加药物不良反应,值得临床参考。
【Objective】To investigate the clinical efficacy of ulinastatin combined with meglumine cyclic adenosine monophosphate in the treatment of viral myocarditis(VMC)and its effect on related apoptotic molecules.【Methods】A total of 106 patients with VMC treated in our hospital were randomly divided into observation group(ulinastatin combined with meglumine cyclophosphate)and control group(meglumine cyclophosphate),with 53 cases in each group.The two groups were treated for 2 weeks.The clinical efficacy,myocardial injury indexes(cardiac troponin I(cTnI),creatine kinase(CK),creatine kinase isoenzyme(CK-MB)),the levels of apoptosis molecules(soluble apoptosis factor(sFas),soluble apoptosis related factor ligand(sFasL))and the incidence of adverse reactions were compared between the two groups.【Results】Tow weeks after treatment,the total effective rate of clinical efficacy in the observation group was 92.45%(49/53),which was significantly higher than 75.47%(40/53)in the control group(χ^(2)=5.68,P=0.017<0.05).After 2 weeks of treatment,the levels of serum cTnI,CK,CK-MB,sFas and sFasL in the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 11.32%(6/53),which was higher than 5.66%(3/53)in the control group,but the difference was not statistically significant(χ^(2)=0.49,P=0.48>0.05).【Conclusion】Ulinastatin combined with meglumine cyclic adenosine monophosphate is effective in the treatment of VMC patients,which can effectively reduce the myocardial injury of patients,which may be related to the inhibition of apoptotic molecules,and the addition of ulinastatin does not significantly increase the adverse drug reactions,which is worthy of clinical reference.
作者
高敏
肖明
周国
GAO Min;XIAO Ming;ZHOU Guo(Shandong Provincial Third Hospital,Jinan Shandong,250031,China)
出处
《医学临床研究》
CAS
2022年第2期281-283,共3页
Journal of Clinical Research
