卡托普利联合磷酸肌酸钠治疗感染性心肌炎的疗效及对血清IMA、HMGB1水平的影响  

Effects of captopril combined with sodium creatine phosphate on treatment of patients with infectious myocarditis influence on serum IMA and HMGB1 levels

作　　者：玉晓[1] 苏雅拉图[2] 佟玉清[1] 根小子 包国宏 YU Xiao;SUYA La-tu;TONG Yu-qing;GEN Xiao-zi;BAO Guo-hong(Affiliated Hospital of Inner Mongolia University for Nationalities,Tongliao,Inner Mongolia 028000,China)

机构地区：[1]内蒙古民族大学附属医院蒙医心内科,内蒙古通辽028000 [2]内蒙古民族大学附属医院蒙医外科,内蒙古通辽028000

出　　处：《中华医院感染学杂志》2022年第15期2289-2293,共5页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区卫健委课题(202201460)。

摘　　要：目的分析卡托普利联合磷酸肌酸钠治疗感染性心肌炎的疗效及对患者血清缺血修饰白蛋白(IMA)、高迁移率蛋白-1(HMGB1)水平的影响。方法选取2018年12月-2020年12月内蒙古民族大学附属医院接诊的155例感染性心肌炎患者作为研究对象,按照随机数字表法将患者分为对照组75例与研究组80例。对照组采用卡托普利进行治疗,研究组在使用卡托普利治疗的基础上加用磷酸肌酸钠进行治疗。观察两组心肌酶水平、心功能指标、肌钙蛋白水平、Treg/CD_(4)^(+)T、肿瘤坏死因子β抗体(TNF-β)、缺血修饰白蛋白(IMA)、高迁移率族蛋白B1(HMGB1)、治疗效果、不良反应发生率。结果与治疗前相比,两组患者治疗后谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)、超敏肌钙蛋白(cTnI)、心肌钙蛋白(cTnT)、Treg/CD_(4)^(+)T、TNF-β、IMA、HMGB1水平降低,左心射血分数(LVEF)、左室短轴缩短率(FS)、左室每搏量(SV)水平升高,且研究组降低/升高幅度高于对照组(P<0.05);研究组治疗总有效率高于对照组(P<0.05)。结论卡托普利联合磷酸肌酸钠可降低感染性心肌炎患者IMA、HMGB1水平异常表达,促进心功能恢复,可用于此病治疗。OBJECTIVE To analyze the effects of captopril combined with sodium phosphocreatine on serum ischemia-modified albumin(IMA)and high mobility protein-1(HMGB1)levels in patients with infectious myocarditis.METHODS A total of 155 patients with infectious myocarditis admitted to the Affiliated Hospital of Inner Mongolia University for Nationalities from Dec 2018 to Dec 2020 were recruited as the research subjects.They were divided into the control group(n=75)and research group(n=80)by using the random number table.The control group was treated with captopril,and the research group was additionally treated with creatine phosphate sodium on the basis of captopril.The levels of myocardial enzymes,cardiac function indexes,troponin,Treg/CD_(4)^(+)T,tumor necrosis factorβantibody(TNF-β),ischemia modified albumin(IMA),high mobility group protein B1(HMGB1),treatment effect,and incidence of adverse reactions between the two groups were observed.RESULTS Compared with before treatment,aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB),creatine kinase(CK),lactate dehydrogenase(LDH),and hydroxybutyrate dehydrogenase(HBDH),high-sensitivity troponin(cTnI),cardiac troponin(cTnT),Treg/CD_(4)^(+)T,TNF-β,IMA and HMGB1 levels in the two groups after treatment were significantly lower,while left ventricular ejection fraction(LVEF),left ventricular short-axis shortening rate(FS)and left ventricular stroke volume(SV)levels increased,and the decrease/increase ratio in the study group was significantly higher than that in the control group(P<0.05).The total effective rate in the treatment group was significantly higher than that in the control group(P<0.05).CONCLUSION Captopril combined with sodium phosphocreatine can reduce the abnormal expressions of IMA and HMGB1 in patients with infectious myocarditis,promote the recovery of cardiac function,and can be used for the treatment of this disease.

关 键 词：卡托普利 磷酸肌酸钠 感染性心肌炎 缺血修饰白蛋白 高迁移率蛋白-1 

分 类 号：R542.21[医药卫生—心血管疾病]