不同剂量磷酸肌酸钠对病毒性心肌炎患儿T淋巴细胞亚群及炎症因子的影响

Effects of Different Doses of Sodium Creatine Phosphate on T Lymphocyte Subsets and Inflammatory Factors in Children with Viral Myocarditis

目的:探讨不同剂量磷酸肌酸钠对儿童病毒性心肌炎T淋巴细胞亚群及血清炎症因子的影响。方法:选取我院2016年5月至2017年4月收治的90例病毒性心肌炎患儿,随机分为高剂量组、中剂量组和低剂量组各30例;选取30例同期在我院体检的健康儿童作为对照组。高剂量组、中剂量组和低剂量组分别采用1.5 g、1.3 g和1.0 g磷酸肌酸钠静脉滴注,每日1次,疗程2~3周,治疗14 d后比较三组患儿的临床疗效、T淋巴细胞亚群及血清炎症因子水平。结果:高剂量组总有效率为96.67%,中剂量组的总有效率为90.00%,低剂量组的总有效率为76.67%(P<0.05);高、中、低三个剂量组患儿治疗后的T淋巴细胞亚群及血清炎症因子水平改善情况均高于治疗前(P<0.05)。治疗后,三组患儿CD4^+、CD8^+、IL-6、IL-8、TNF-α水平比较差异有统计学意义(P均<0.05)。高剂量组、中剂量组患儿的T淋巴细胞亚群水平高于低剂量组(P<0.05);高剂量组、中剂量组患儿的IL-6、IL-8和TNF-α等血清炎症因子水平高于低剂量组(P<0.05)。结论:磷酸肌酸钠对病毒性心肌炎患儿T淋巴细胞亚群及血清炎症因子水平的影响与治疗剂量呈正相关且具有良好的安全性。

Objective: To investigate the effects of different doses of sodium creatine phosphate on T lymphocyte subsets and inflammatory factors in children with viral myocarditis. Methods: Ninety children with viral myocarditis admitted to our hospital from May 2016 to April 2017 were randomly divided into the high dose group,the medium dose group and the low dose group,with 30 cases in each group,and 30 healthy children were selected as the control group during the same period. The high dose group,the medium dose group and the low dose group were respectively given 1. 5 g,1. 3 g and 1. 0 g sodium creatine phosphate intravenously,qd,for 2 to 3 weeks. After treatment of 14 d,the clinical efficacy,T lymphocyte subsets and inflammatory factors were compared among three groups.Results: The total effective rate was 96. 67% in the high dose group and 90. 00% in the medium dose group,higher than 76. 67% in the low dose group( P<0. 05). The improvement of T lymphocyte subsets and inflammatory factors in the high,medium and low dose group after treatment was higher than that before treatment( P< 0. 05). After treatment,there were significant differences in levels of CD4^+,CD8^+,IL-6,IL-8 and TNF-α among three groups( P<0. 05). The levels of T lymphocyte subsets in the high dose group and the medium dose group were higher than those in the low dose group( P<0. 05). The levels of inflammatory factors such as IL-6,IL-8 and TNF-α in the high dose group and the medium dose group were significantly higher than those in the low dose group( P<0. 05). Conclusion: The efficacy of sodium creatine phosphate on T lymphocyte subsets and inflammatory factor levels in children with viral myocarditis is positively correlated with the therapeutic dose and shows higher safety.