左卡尼汀治疗病毒性心肌炎疗效及对心肌损伤标志物、炎症因子的影响

Curative effect of levocarnitine on viral myocarditis and its influence on biomarkers of myocardial damage and inflammatory factors

目的观察左卡尼汀注射液治疗病毒性心肌炎临床疗效,并分析其对心肌损伤标志物和炎症因子的影响。方法以同济医院2018年1月至2018年12月收治的病毒性心肌炎患儿为研究对象,随机分为对照组和观察组(各35例)。对照组给予抗病毒、磷酸肌酸钠营养心肌等综合治疗,观察组在综合治疗基础上加用左卡尼汀注射液1.0 g,1/d,静脉滴注,连续使用1周。比较两组患儿血清心肌损伤标志物如肌酸激酶同工酶(CK-MB)、血浆N末端脑钠肽前体(NT-proBNP)和心肌肌钙蛋白(cTnI),以及炎症因子白介素6(IL-6)、白介素10(IL-10)及肿瘤坏死因子α(TNF-α)水平,观察两组治疗效果。结果观察组治疗总有效率显著高于对照组,差异有统计学意义(94.3%vs.77.1%,P<0.05),且观察组血清中CK-MB、NT-proBNP、cTnI及IL-6、IL-10、TNF-α水平下降幅度显著优于对照组,组间对比差异有统计学意义(P<0.05)。结论左卡尼汀注射液能降低炎症因子及心肌损伤水平,提升病毒性心肌炎患儿的临床治疗效果。

Objective To observe the clinical efficacy of levocarnitine injection on viral myocarditis(VMC),and analyze its influence on biomarkers of myocardial damage and inflammatory factors.Methods VMC patients were chosen from Tongji Hospital from Jan.2018 to Dec.2018,and then divided randomly into control group and observation group(each n=35).The control group was given comprehensive therapy such as antiviral therapy and creatine phosphate sodium for myocardial nutrition,and observation group was additionally given intravenous drip of levocarnitine injection(1.0 g)once a day for 1 week.The levels of biomarkers of myocardial damage including creatine kinase-MB isoenzyme(CK-MB),N-terminal pro-brain natriuretic peptide(NT-proBNP)and cardiac troponin I(cTnI),and levels of inflammatory factors including interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)were compared between 2 groups.The curative effect was observed in 2 groups.Results The total effective rate was significantly higher in observation group than that in control group(94.3%vs.77.1%,P<0.05).The levels of serum CK-MB,NT-proBNP,cTnI,IL-6,IL-10 and TNF-αwere significantly lower in observation group than those in control group(P<0.05).Conclusion Levocarnitine injection can reduce inflammatory factor level and relieve myocardial damage,and promote clinical efficacy in VMC patients.