大剂量维生素C辅助免疫球蛋白治疗感染病毒性心肌炎的临床疗效  

Clinical effect of high-dose vitamin C combined with immunoglobulin in the treatment of infectious viral myocarditis

作　　者：郭红前 GUO Hong-qian(Department of Cardiology,Shandong Taishan Nursing Home,Tai'an 271000,China)

机构地区：[1]山东省泰山疗养院心内科,271000

出　　处：《中国实用医药》2021年第5期4-7,共4页China Practical Medicine

摘　　要：目的探讨大剂量维生素C辅助免疫球蛋白治疗感染病毒性心肌炎(VMC)的临床疗效。方法 58例感染病毒性心肌炎患儿,采用抽签法分为对照组及观察组,每组29例。两组均予以常规对症治疗,对照组采用免疫球蛋白治疗,观察组在对照组基础上加用大剂量维生素C治疗。对比两组临床疗效,治疗前、治疗2周后的心肌酶谱指标[肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)]及炎症因子[白细胞介素-17(IL-17)、细胞间粘附分子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)]水平。结果观察组治疗总有效率93.10%高于对照组的72.41%,差异有统计学意义(P<0.05)。治疗2周后,两组CK-MB、LDH、CK均较治疗前降低,且观察组CK-MB(23.47±4.38)U/L、LDH(156.51±6.87)U/L、CK(153.87±67.20)U/L低于对照组的(33.56±5.20)、(188.04±9.27)、(251.33±82.46)U/L,差异有统计学意义(P<0.05)。治疗2周后,两组IL-17、ICAM-1、TNF-α水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。结论大剂量维生素C辅助免疫球蛋白治疗感染病毒性心肌炎患儿疗效显著,能够显著改善患儿心肌酶谱水平,降低炎症因子水平,值得临床推广。Objective To discuss the clinical efficacy of high-dose vitamin C combined with immunoglobulin in the treatment of infectious viral myocarditis(VMC).Methods A total of 58 children with infectious viral myocarditis were divided into control group and observation group according to lottery method,with 29 cases in each group.Both groups received conventional symptomatic treatment.The control group was treated with immunoglobulin,and the observation group was treated with high-dose vitamin C on the basis of the control group.The clinical efficacy,myocardial enzyme spectrum indexes[creatine kinase isoenzyme(CK-MB),creatine kinase(CK),lactate dehydrogenase(LDH)]and inflammatory factor[interleukin-17(IL-17),intercellular adhesion molecule-1(ICAM-1),tumor necrosis factor-α(TNF-α)levels before treatment and 2 weeks after treatment were compared between the two groups.Results The total effective rate of treatment 93.10%of the observation group was higher than 72.41%of the control group,and the difference was statistically significant(P<0.05).2 weeks after treatment,the CK-MB,LDH and CK of the two groups were lower than those before treatment,and CK-MB(23.47±4.38)U/L,LDH(156.51±6.87)U/L and CK(153.87±67.20)U/L of the observation group were lower than(33.56±5.20),(188.04±9.27)and(251.33±82.46)U/L of the control group,and the difference was statistically significant(P<0.05).2 weeks after treatment,the IL-17,ICAM-1 and TNF-αof the two groups were lower than those before treatment,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).Conclusion High-dose vitamin C combined with immunoglobulin has remarkable efficacy in the treatment of infectious viral myocarditis,which can significantly improve the levels of myocardial enzymes and reduce the levels of inflammatory factors in children.It is worthy of clinical promotion.

关 键 词：病毒性心肌炎 大剂量维生素C 免疫球蛋白 心肌酶谱指标 

分 类 号：R725.4[医药卫生—儿科]