伊伐布雷定联合常规药物治疗小儿病毒性心肌炎的临床效果分析

Clinical Effect of Ivabradine Combined with Conventional Drugs in the Treatment of Viral Myocarditis in Children

目的:分析伊伐布雷定联合常规药物治疗小儿病毒性心肌炎(VMC)的临床效果。方法:选取2020年7月—2022年7月淮安市妇幼保健院收治的VMC患儿94例作为研究对象,依据随机数字表法分为观察组与对照组,各47例。对照组给予常规治疗,观察组在对照组基础上应用盐酸伊伐布雷定治疗。比较两组治疗效果。结果:观察组治疗总有效率、白细胞介素-4水平高于对照组,血清γ干扰素、单核细胞趋化蛋白-1、血清淀粉样蛋白、心肌肌钙蛋白T、B型钠尿肽前体水平以及外周血Toll样受体3(TLR3)、β干扰素TIR结构域衔接蛋白(TRIF)、核因子-κBp65表达量低于对照组,差异有统计学意义(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:伊伐布雷定联合常规药物治疗VMC的效果较好,可通过抑制TLR3/TRIF信号通路减轻炎性反应,改善患者心功能,且安全性高。

Objective:To analyze the clinical effect of ivabradine combined with conventional drugs in the treatment of viral myocarditis(VMC)in children.Methods:Ninety-four children with VMC admitted to Huai'an Maternal and Child Health Hospital from July 2020 to July 2022 were selected as the study objects,and were divided into observation group and control group according to random number table method,with forty-seven cases in each group.The control group was given conventional treatment,and the observation group was treated with ivabradine hydrochloride on the basis of the control group.The therapeutic effect of the two groups was compared.Results:The total effective rate and the level of interleukin-4 in the observation group were higher than those in the control group,the levels of serum gamma-interferon,monocyte chemoattractant protein-1,serum amyloid protein,cardiac troponin T,B-type natriuretic peptide precursor,and the expression levels of toll-like receptor 3(TLR3),β-interferon TIR domain adaptor protein(TRIF)and nuclear factor-κBp65 in peripheral blood were lower than those in control group,with statistical significance(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ivabradine combined with conventional drugs has a good effect in the treatment of VMC,can reduce inflammatory response and improve cardiac function by inhibiting TLR3/TRIF signaling pathway,and has high safety.