依达拉奉联合黄芪注射液对病毒性心肌炎心肌酶及炎性因子的影响

Effect of Edaravone Combined with Huangqi Injection(黄芪注射液)on Myocardial Enzyme and Inflammatory Factors of Patients with Viral Myocarditis

目的探讨依达拉奉联合黄芪注射液对病毒性心肌炎(viral myocarditis,VMC)患者心肌酶及炎性因子的影响。方法回顾性分析2019年12月—2021年1月医院收治的病毒性心肌炎患者120例,根据治疗方法不同分为对照组和观察组。对照组患者在抗感染、改善心肌代谢等常规治疗基础上联合依达拉奉治疗,观察组患者在对照组治疗基础上联合黄芪注射液治疗。观察并比较两组患者症状和体征恢复时间、心肌酶、氧化应激指标、炎性因子及血液流变学指标水平变化情况。结果观察组治疗后头晕乏力、心悸、脉结促、皮肤湿冷及心音低钝恢复时间均短于对照组(P<0.05)。两组患者治疗后谷草转氨酶(Aspartate transaminase,AST)、肌酸激酶同工酶质量(Creatine Kinase-MBmass,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、丙二醛(malondialdehyde,MDA)及一氧化氮(nitric oxide,NO)水平均较治疗前下降,且观察组治疗后AST、CK-MB、LDH、MDA及NO水平低于对照组治疗后(P<0.05)。两组患者治疗后肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-8(interleukin-8,IL-8)及白细胞介素-6(interleukin-6,IL-6)水平均较治疗前下降,且观察组治疗后TNF-α、IL-8及IL-6水平低于对照组治疗后(P<0.05)。两组患者治疗后全血黏度(高切、中切、低切)、纤维蛋白原及红细胞压积水平均较治疗前下降,观察组治疗后全血黏度(高切、中切、低切)、纤维蛋白原及红细胞压积水平均低于对照组治疗后(P<0.05)。结论依达拉奉联合黄芪注射液治疗病毒性心肌炎患者可有效改善患者症状和体征,降低患者心肌酶水平,减轻氧化应激和炎性反应对心肌细胞的损伤作用。

Objective To investigate the effect of edaravone combined with Huangqi Injection(黄芪注射液)on myocardial en⁃zyme and inflammatory factors of patients with viral myocarditis.Methods A total of 120 patients with viral myocarditis admitted to the hospital from December 2019 to January 2021 were retrospectively analyzed and divided into control group and observation group according to different treatment methods.The patients in the control group were treated with edaravone on the basis of con⁃ventional treatment such as anti-infection and improving myocardial metabolism,while those in the observation group were trea⁃ted with Huangqi Injection on the basis of the treatment in the control group.The changes of symptoms and signs recovery time,myocardial enzymes,oxidative stress indicators,inflammatory factors and hemorheology indicators in the two groups were observed and compared.Results The recovery time of dizziness,weakness,palpitation,tachycardia,wet and cold skin and heart sound dull⁃ness in the observation group were shorter than those in the control group(P<0.05).The levels of aspartate transaminase(AST),creatine kinase-MBmass(CK-MB),lactate dehydrogenase(LDH),malondialdehyde(MDA)and nitric oxide(NO)in the two groups decreased compared with those before treatment,and the levels of AST,CK-MB,LDH,MDA and NO in the ob⁃servation group were lower than those in the control group after treatment(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and interleukin-6(IL-6)in the two groups after treatment were lower than those before treatment,and the levels of TNF-α,IL-8 and IL-6 in the observation group after treatment were lower than those in the con⁃trol group after treatment(P<0.05).After treatment,the whole blood viscosity(high shear,middle shear and low shear),fibrino⁃gen and hematocrit of the two groups were decreased on average compared with those before treatment.After treatment,the whole blood viscosity(high shear,middle shear and low shear),fibrinogen and hematocrit of the observation group were lower than those of the control group(P<0.05).Conclusion Edaravone combined with Huangqi Injection in the treatment of patients with viral myocarditis can effectively improve the symptoms and signs,reduce the myocardial enzyme level of patients,reduce the damage of oxidative stress and inflammatory reaction on myocardial cells.