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

作　　者：冯地 李丹 徐春芝 Feng Di;Li Dan;Xu Chunzhi(Zhoukou People's Hospital,Henan 466000)

机构地区：[1]周口市人民医院,河南466000

出　　处：《天津药学》2024年第2期29-32,共4页Tianjin Pharmacy

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(c TnT)、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c TnT、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。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 number table method,with 32 patients in each group.The control group was given a cAMP injection(40 mg dissolved in 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-γwere 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 pa

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 

分 类 号：R542.21[医药卫生—心血管疾病]