参麦注射液对病毒性心肌炎病人外周血自噬及凋亡相关蛋白表达的影响

Effect of Shenmai Injection on Expression of Autophagy and Apoptosis-related Proteins in Peripheral Blood of Patients with Viral Myocarditis

目的探讨参麦注射液对病毒性心肌炎病人外周血自噬及凋亡相关蛋白表达的影响。方法选取2018年1月—2020年7月在重庆市黔江中心医院心血管内科住院的病毒性心肌炎病人152例为研究对象,根据随机数字表法将病人分为观察组和对照组,每组76例。对照组给予常规治疗,观察组在对照组基础上给予参麦注射液治疗,疗程为2周。比较两组治疗前后外周血单核细胞(PBMC)自噬相关基因(Beclin-1和LC3-Ⅱ)mRNA及蛋白表达水平,凋亡相关基因(Caspase-3、Bcl-2)mRNA水平,相关炎性细胞因子[白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α]水平,心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)及左室收缩末期内径(LVESD)]及不良反应发生情况。结果与治疗前比较,治疗后两组外周血自噬相关基因Beclin-1、LC3-ⅡmRNA和蛋白表达及凋亡相关基因Caspase-3 mRNA水平均降低(P<0.05),其中观察组上述指标降低更明显;同时与治疗前比较,治疗后两组外周血抗凋亡相关基因Bcl-2 mRNA水平明显升高(P<0.05),其中观察组Bcl-2 mRNA水平升高更明显(P<0.05)。治疗后,观察组外周血IL-6、TNF-α水平明显低于对照组(P<0.05);治疗后,观察组LVEF明显高于对照组,LVEDD、LVESD明显低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论参麦注射液可降低病毒性心肌炎病人外周血自噬及凋亡相关蛋白的表达水平,抑制炎症反应,改善心功能。

Objective To explore the effect of Shenmai Injection on the expression of autophagy and apoptosis-related proteins in peripheral blood of patients with viral myocarditis.Methods A total of 152 patients with viral myocarditis hospitalized from January 2018 to July 2020 were selected as the research objects.According to the random number table method,the patients were divided into the observation group and the control group,with 76 cases in each group.The control group was given conventional treatment,and the observation group was given Shenmai Injection on the basis of the control group,the course of treatment was 2 weeks.The mRNA and protein expression levels of autophagy related genes(Beclin-1 and LC3-Ⅱ),apoptosis related genes(Caspase-3 and Bcl-2)in peripheral blood mononuclear cells(PBMC),the levels of related inflammatory cytokines[interleukin(IL)-6,tumor necrosis factor(TNF)-α],and cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)]were compared between two groups before and after treatment.The occurrence of adverse reactions were recorded.Results Compared with before treatment,the mRNA and protein expressions of Beclin-1 and LC3-Ⅱand the mRNA levels data in peripheral blood of two groups were decreased after treatment,and the above indexes in the observation group were decreased more significantly(P<0.05).Compared with data before treatment,the mRNA level of anti-apoptosis-related gene Bcl-2 in peripheral blood of two groups were significantly increased after treatment,and the mRNA level of Bcl-2 in the observation group was more significantly increased(P<0.05).After treatment,the levels of IL-6 and TNF-αin peripheral blood of the observation group were significantly lower than those of the control group(P<0.05).After treatment,the LVEF of the observation group was significantly higher than that of the control group,and the LVEDD and LVESD of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Shenmai Injection can reduce the expression levels of autophagy and apoptosis-related proteins in peripheral blood of patients with viral myocarditis,inhibit inflammation and improve cardiac function.