槐果碱注射液治疗病毒性心肌炎的临床研究

A clinical research of sophocarpine in treatment of viral myocarditis

目的:分析槐果碱治疗病毒性心肌炎(VMC)的临床研究情况。方法:将VMC患者600例分为2组:槐果碱组450例(其中PCR柯萨奇B病毒(CVB)-RNA与中和抗体同时阳性90例);GIK组150例(其中PCR CVB-RNA与中和抗体同时阳性40例)。结果:槐果碱组90例CVB-RNA阳性者中经治疗后有75例CVB-RNA消失,占83.3%。GIK组40例CVB-RNA阳性者中治疗后仅4例消失,占10%。槐果碱组临床症状总有效率为93.73%,GIK组为50.00%,槐果碱组抗心律失常的总有效率为89.79%,其中期前收缩消失达90%以上的显效率为77.55%,而GIK组总有效率为63.82%,其中期前收缩消失达90%以上的显效率仅为29.78%,2组差异有统计学意义(P<0.01)。据EKG所测NST及ΣST参数的改变提示槐果碱组优于GIK组,槐果碱对UCG所测射血分数、每搏量、心排血量、心脏指数等参数有明显改善,与GIK组相比,均P<0.05,并能提高NK细胞活性,使CD3、CD4、CD8、CD4/CD8提高或调节至正常水平,而GIK组则未见明显改变。结论:槐果碱是有效治疗VMC的药物,既能对抗病毒,又能对抗心律失常并能调节免疫功能,改善心功能。

Objective： Analysis the therapeutic effect of sophocarpine in the treatment of viral myocarditis within several years of our hospital. Method：All 600 patients are accorded to in the diagnostic criterion of viral myocarditis with Chinese Journal of Cardiology. They are divided into 2 groups：①sophocarpine group 450 cases including CVB-RNA and neutralization antibody positive reaction 90 cases; ②GIK group 150 cases including CVB-RNA and neutralization antibody positive reaction 40 cases. Result： Among sophocapine group, there were 75/90 cases CVBRNA disappeared occupied 83%. Among GIK group there were only 4/40 cases CVB-RNA disappeared occupied 10 %. Sophocarpine therapeutic group, relieved the clinical symptom 93.73%. GIK group only relieved 58%. Sophoearpine anti-arrhythmic effect reached 89.7 % （diminish 2〉90% premature beat 77.55%）. GIN group only relieved 63%（diminish 2〉90% premature beat 29. 78%）. Sophocarpine was better than GIK group （ P 〈0.01 ）. Parameter of NST and ∑ST which determined by EKG in Sophocarpine group was better than GIK group. It point out Sophocarpine could improve myocardial ischemia and decrease oxygen consumption. Parameters of EF, SV, CO, CI determined by UCG in Sophocarpine group were better than GIK group （ P 〈0.01 ）. Parameters of NK cell activity and cell-mediated immunity CD3, CD4, CDS, CD4/CD8 in Sophocarpine group were increased or moderated to normal value, while in GIN group only little changed. Conclusion： Sophocarpine is an effective drug for the treatment of viral myocarditis. Not only the effect on antivirus, but also had the effect on antiarrhythmia, modulating the cell mediated immunity and improving the myocardial function.