| 孙 敏,王 涛,李 健,王娟莉,行海舰.免疫球蛋白联合磷酸肌酸钠对病毒性心肌炎患儿心肌重塑和心肌损伤的影响[J].,2020,(24):4692-4695 |
| 免疫球蛋白联合磷酸肌酸钠对病毒性心肌炎患儿心肌重塑和心肌损伤的影响 |
| Effect of Immunoglobulin Combined with Sodium Creatine Phosphate on Myocardial Remodeling and Myocardial Injury in Children with Viral Myocarditis |
| 投稿时间：2020-04-23 修订日期：2020-05-18 |
| DOI：10.13241/j.cnki.pmb.2020.24.020 |
| 中文关键词: 免疫球蛋白 磷酸肌酸钠 病毒性心肌炎 心肌重塑 心肌损伤 |
| 英文关键词: Immunoglobulin Sodium Creatine Phosphate Viral Myocarditis Myocardial Remodeling Myocardial Injury |
| 基金项目:国家自然科学基金项目（81873513） |
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| 中文摘要: |
| 摘要 目的：研究免疫球蛋白联合磷酸肌酸钠对病毒性心肌炎患儿心肌重塑和心肌损伤的影响。方法：选择2017年1月～2019年12月我院收治的143例病毒性心肌炎患儿，随机分为两组。对照组静脉输注磷酸肌酸钠治疗，每次0.5～1.0 g，每天1次，连用14 d。观察组联合静脉注射人免疫球蛋白，剂量1 g/(kg?d)，每天1次，连用2 d。检测两组治疗前后的心肌重塑指标和心肌损伤指标变化情况。结果：观察组的有效率明显高于对照组（P<0.05）；治疗前，两组的血清血清转化生长因子β1(transforming growth factor-β1，TGFβ1）、I型前胶原氨基端肽(nitrogen terminal propeptide of type I procollagen，PINP）、基质金属蛋白酶(matrix metalloproteinase-2，MMP2）、I型胶原吡啶交联终肽(type I collagen carboxy terminal telopeptide，ICTP）、MMP9水平无明显差异（P>0.05），治疗后，两组的血清TGFβ1、PINP、MMP2、ICTP、MMP9水平均明显降低（P<0.05），且观察组的血清TGFβ1、PINP、MMP2、ICTP、MMP9水平明显低于对照组（P<0.05）；治疗前，两组的血清血清丙二醛(malondialdehyde，MDA）、心肌肌钙蛋白I(Cardiac troponini，cTnI）、脑利钠肽(B -type natriuretic peptide，BNP）、肌酸激酶同工酶(Creatine kinase isoenzyme，CK-MB）水平无明显差异（P>0.05），治疗后，两组的血清MDA、CK-MB、BNP和cTnI水平均明显降低（P<0.05），且观察组的血清MDA、CK-MB、BNP和cTnI水平明显低于对照组（P<0.05）。结论：免疫球蛋白联合磷酸肌酸钠对病毒性心肌炎患儿有显著的疗效，能有效抑制心肌重塑、减轻心肌损伤，值得进行推广。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of immunoglobulin combined with sodium creatine phosphate on myocardial remodeling and myocardial injury in children with viral myocarditis. Methods: Selected 143 cases of children with viral myocarditis who were treated in our hospital from January 2017 to December 2019, divided into two groups randomly. In the control group, sodium creatine phosphate was infused intravenously, 0.5~1.0 g each time, once a day for 14 days. The observation group combined with intravenous injection of human immunoglobulin at a dose of 1 g/(kg?d), once a day for 2 days. The changes of myocardial remodeling index and myocardial injury index were detected before and after treatment. Results: The effective rate of the observation group was significantly higher than control group (P<0.05). Before treatment, there was no significant difference in the levels of TGF β 1, PINP, MMP2, ICTP and MMP9 between the two groups (P>0.05), after treatment, the levels of TGF β 1, PINP, MMP2, ICTP and MMP9 in the two groups were significantly reduced (P<0.05), the levels of TGF β 1, PINP, MMP2, ICTP and MMP9 in the observation group were significantly lower than those in the control group (P<0.05). Before treatment, there was no significant difference in the levels of MDA, CK-MB, BNP and cTnI between the two groups (P>0.05), after treatment, the levels of MDA, CK-MB, BNP and cTnI in the two groups were significantly reduced (P<0.05), the levels of MDA, CK-MB, BNP and cTnI in the observation group were significantly lower than those in the control group(P<0.05). Conclusion: Immunoglobulin combined with sodium creatine phosphate has a significant effect on children with viral myocarditis. It can effectively inhibit myocardial remodeling and reduce myocardial damage, which is worthy of promotion. |
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