黄芪注射液联合利巴韦林对老年病毒性心肌炎患者内质网应激的影响

Effect of Astragalus Injection Combined with Ribavirin on Endoplasmic Reticulum Stress in Older Persons with Viral Myocarditis

目的 观察黄芪注射液联合利巴韦林对老年病毒性心肌炎(VMC)患者内质网应激(ERS)的影响,分析其临床疗效。方法 选择2018年3月~2020年1月海南西部中心医院心血管内科治疗的116例老年VMC患者作为研究对象,按照随机数字表法分为观察组和对照组,各58例。对照组给予利巴韦林,0.5 g/d静脉滴注,观察组在对照组基础上给予黄芪注射液,20 ml静脉滴注,1次/d,两组疗程均为7 d。酶联免疫吸附试验检测心肌损伤标志物[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、乳酸脱氢酶(LDH)]和ERS标志物[内质网应激蛋白(CHOP)和分子伴侣葡萄糖调节蛋白78(GRP78)]。结果 两组治疗前CK-MB、cTnT、LDH、CHOP和GRP78水平比较,差异均无统计学意义(P>0.05);治疗后,两组CK-MB、cTnT、LDH、CHOP和GRP78水平均低于治疗前,且观察组各指标均低于对照组,差异均有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。两组不良反应的总发生率比较,差异无统计学意义(P>0.05)。结论 黄芪注射液联合利巴韦林可以显著抑制老年VMC患者ERS,保护心功能,临床疗效显著,使用安全。

Objective To observe the effect of astragalus injection combined with ribavirin on endoplasmic reticulum stress(ESR) in older patients with viral myocarditis(VMC).Methods A total of 116 older patients with VMC treated in Hainan Western Central Hospital from March 2018 to January 2020 were selected as the research objects.The patients were divided into an observation group(n=58) and a control group(n=58) according to random number table.Both groups were given ribavirin(0.5 g/d) for 7 days, the observation group was additionally given astragalus injection(20 ml) once a day for 7 days.The levels of creatine kinase MB(CK-MB),cardiac troponin T(cTnT),lactate dehydrogenase(LDH),CHOP,and glucose regulated protein 78(GRP78) were measured by enzyme linked immunosorbent assay.Results Before treatment, there were no significant differences in the levels of CK-MB,cTnT,LDH,CHOP,or GRP78 between the two groups(P>0.05).After treatment, the levels of CK-MB,cTnT,LDH,CHOP,and GRP78 in the two groups were decreased, and the levels of above indicators in the observation group were significantly lower than those in the control group(P<0.05).The overall response rate in the observation group was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Astragalus injection combined with ribavirin may significantly inhibit ERS in older patients with VMC and protect heart function, with a significant clinical effect and safety.