静滴左卡尼汀与环磷腺苷联合治疗病毒性心肌炎效果观察
Observation on the effect of intravenous levocarnitine combined with cyclic adenosine monophosphate in the treatment of viral myocarditis
冯地 1李丹 1徐春芝1
作者信息
摘要
目的:探讨静滴左卡尼汀与cAMP联合治疗病毒性心肌炎(VMC)的具体疗效.方法:选择2020 年 1 月—2022 年 12 月本院收治的 64 例VMC患者,按随机数字表法分为两组,各 32 例.对照组予以cAMP注射液 40 mg溶于250 ml 5%葡萄糖注射液中静脉滴注,1 次/d;观察组于对照组基础上加用左卡尼汀注射液 10～20 mg/kg溶于 250 ml 5%葡萄糖注射液中静脉滴注,1 次/d.两组持续治疗14 d.比较两组临床疗效、血清炎症因子水平、心肌损伤标志物水平、不良反应.结果:观察组总有效率为96.88%(31/32),显著高于对照组的71.88%(23/32),差异有统计学意义(P＜0.05);治疗前,两组白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)比较,差异无统计学意义(P＞0.05),治疗后,观察组IL-4 水平较对照组高,IL-6、TNF-α和IFN-γ水平较对照组低,差异有统计学意义(P＜0.05);治疗前,两组心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)和血浆N末端脑钠肽前体(NT-proBNP)比较,差异无统计学意义(P＞0.05),治疗后,观察组cTnT、CK-MB和NT-proBNP均低于对照组,差异有统计学意义(P＜0.05);观察组不良反应发生率为 15.63%(5/32),与对照组的 9.38%(3/32)比较,差异无统计学意义(P＞0.05).结论:VMC患者采用左卡尼汀联合cAMP治疗,可在一定程度上增强患者的临床疗效,进一步缓解炎性反应,减轻心肌损伤,且用药安全性较高.
Abstract
Objective:To explore the specific efficacy of intravenous infusion of levocarnitine combined with cyclic adenosine monophosphate(cAMP)for the treatment of viral myocarditis(VMC).Methods:64 VMC patients admitted to our hospital from January 2020 to December 2022 were selected and randomly divided into two groups according to the random numbertablemethod,with32patientsineachgroup.ThecontrolgroupwasgivenacAMPinjection(40mgdissolvedin 250 ml of 5%glucose injection)once a day.The observation group was administered L-carnitine injection 10～20 mg/kg dissolved in 250 ml of 5%glucose intravenously,once a day.Both groups were treated for 14 days.Clinical efficacy,serum inflammatory factors,myocardial injury markers,and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 96.88%(31/32),significantly higher than that of the control group 71.88%(23/32),and the difference was statistically significant(P＜0.05).Before treatment,there were no significant differences in interleukin-4(IL-4),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and interferon-γ(IFN-γ)between the two groups(P＞0.05).After treatment,the levels of IL-4 in the observation group were higher than those in the control group,while the levels of IL-6,TNF-α,and IFN-γ were significantly lower in the observation group than in the control group(P＜0.05).Before treatment,there was no significant difference in cardiac troponin T(cTnT),creatine kinase isoenzyme(CK-MB),and plasma N-terminal brain natriuretic peptide precursor(NT-proBNP)levels between the two groups(P＞0.05).After treatment,cTnT,CK-MB,and NT-proBNP levels were significantly lower in the observation group than in the control group(P＜0.05).The incidence of adverse reactions in the observation group was 15.63%(5/32)compared with 9.38%(3/32)in the control group,and the difference was not statistically significant(P＞0.05).Conclusion:The combination of levocarnitine and cAMP treatment can enhance the clinical efficacy of VMC patients to a certain extent,further alleviate inflammatory reactions,reduce myocardial injury,and have high drug safety.
关键词
病毒性心肌炎/左卡尼汀/环磷腺苷/炎症因子/心肌损伤标志物Key words
viral myocarditis/levocarnitine/adenosine cyclic phosphate/inflammatory factors/myocardial injury markers引用本文复制引用
出版年
2024
NETL
NSTL
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