急性重症心肌炎临床疗效探讨

Observation on the Clinical Curative Effect of Acute Severe Myocarditis

目的探讨治疗急性重症心肌炎疾病的有效方法及疗效,用于指导临床治疗。方法随机选取2012年12月—2014年12月来该院进行诊治的急性重症心肌炎患者80例,将其随机分为两组,观察组和照组。观察组患者采用综合治疗（维生素、地塞米松等）,观察组患者在对照组基础上加用丙种球蛋白治疗。观察并比较观察组和对照组病患,然后比较治疗前及治疗一个月后的心功能指标,其中心功能指标包括左心室内径（LV）、左心室射血分数（LVEF）。结果观察组患者临床疗效明显强于对照组,观察组临川疗效方面的总有效率（92.5%）明显高于对照组（72.5%）,观察组患者显效23例、对照组患者显效17例;观察组患者有效14例、对照组患者有效12例;观察组患者无效3例、对照组患者无效11例;观察组患者临床疗效明显比对照组的临床疗效好,差异有统计学意义（χ~2=13.950,P=0.025）;治疗前两组患者LV、LVEF比较,差异无统计学意义（P〉0.05）;治疗1个月后观察组患者LV明显比对照组低,而LVEF比对照组高,差异有统计学意义（P〈0.05）。而且心室内径和心室射血分数在采用丙种球蛋白治疗急性重症心肌炎疾病一个月后明显发生改善。结论使用丙种球蛋白治疗急性重症心肌炎疗效良好,安全性高,值得临床推广。

Objective To discuss the effective method and curative effect of treating acute severe myocarditis to guide the clinical treatment. Methods 80 cases of patients with acute severe myocarditis diagnosed and treated in our hospital from December 2012 to December 2014 were selected and randomly divided into two groups, the control group received the combined treatment of vitamin and dexamethasone, the observation group were given additional gamma globulin treatment on the basis of the control group, the cardiac function indexes including left ventricular internal diameter and left ventricular e- jection fraction before treatment and in a month after treatment were compared. Results The total effective rate in of the cu- rative effect in the observation group was obviously higher than that in the control group（92.5% vs72.5%）, in the observation group, 23 cases were markedly effective, 14 cases were effective, 3 cases were ineffective, in the control group, 17 cases were markedly effective, 12 cases were effective, 11 cases were ineffective, the clinical curative effect in the observation group was obviously higher than that in the control group, the difference was statistically significant （Chi-square value was 13.950,P=0.025）, the differences in LV and LVEF before treatment were not statistically significant （P〉0.05）; the LV in the observation group was obviously lower than that in the control group in a month after treatment, and the LVEF in the observation group was higher than that in the control group and the difference was statistically significant （P〈0.05）, and the ventricular internal diameter and ventricular ejection fraction were obviously improved by using gamma globulin treatment for acute severe myocarditis for a month. Conclusion The gamma globulin treatment for acute severe myocarditis for a month has a good curative effect and high security, which is worth promoting in clinic.