Icariin ameliorates viral myocarditis by inhibiting TLR4-mediated ferroptosis

Objective:To explore the mechanism by which icariin alleviates viral myocarditis.Methods:CVB3-induced cardiomyocytes were used as an in vitro model of viral myocarditis to assess the effects of icariin treatment on cell viability,inflammation,and apoptosis.Moreover,the effects of icariin on ferroptosis and TLR4 signaling were assessed.After AC16 cells were transfected with TLR4 overexpression plasmids,the role of TLR4 in mediating the regulatory effect of icariin in viral myocarditis was investigated.Results:Icariin significantly elevated cell viability and reduced inflammatory factors TNF-α,IL-1β,IL-6,and IL-18.Flow cytometry revealed that icariin decreased apoptosis rate,and the protein expression of Bax and cleaved caspase 3 and 9 in CVB3-induced cardiomyocytes.Additionally,it suppressed ferroptosis including lipid peroxidation and ferrous ion,as well as the TLR4 signaling.However,TLR4 overexpression abrogated the modulatory effects of icariin.Conclusions:Icariin mitigates CVB3-induced myocardial injury by inhibiting TLR4-mediated ferroptosis.Further animal study is needed to verify its efficacy.

曲美他嗪辅助环磷腺苷葡胺治疗VMC患者的效果观察

目的:探讨曲美他嗪辅助环磷腺苷葡胺治疗病毒性心肌炎(Viralmyocarditis,VMC)患者对外周血T淋巴细胞、心肌酶谱的影响。方法:选取我院2020年10月至2021年12月收治的80例VMC患者为研究对象,随机分为对照组与观察组,各40例,对照组采用环磷腺苷葡胺治疗,观察组在对照组基础上联用曲美他嗪。治疗2 w后,对比两组临床疗效、心功能、血清T淋巴细胞亚群水平、心肌酶谱及不良反应发生情况。结果:观察组的临床有效率较对照组高(P<0.05);观察组的左心室射血分数、心脏指数均较对照组高(P<0.05);观察组的血清谷草转氨酶、肌酸激酶和肌酸激酶同工酶水平均较对照组低(P<0.05);观察组的CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)均较对照组高(P<0.05),CD8^(+)水平较对照组低(P<0.05);两组治疗期间不良反应发生率无统计学差异(P>0.05)。结论:曲美他嗪辅助环磷腺苷葡胺治疗VMC临床疗效显著,有助改善患者心肌酶谱,改善心功能,提高免疫功能。

Impairment of Myocardial and Skeletal Mitochondria in Mice with Viral Myocarditis and Their Correlation

In order to investigate the impairment of mitochondrial membrane phospholipid local- ization and DNA3867 (mtDNA3867) deletion and the correlation between cardiac and skeletal muscle cells in mice with viral myocarditis, 50 BALB/c mice were divided into two groups randomly. In ex- perimental group (n=40), the mice were intraperitoneally injected with 0.1 mL Eagle liquid with CVB3 (TCID50=108), while in the control group (n=10), the mice were subjected to equal volume of Eagle liquid. The impairment of mitochondrial membrane phospholipid localization and mtDNA3867 deletion rate of cardiac and skeletal muscle were detected separately at day 3, 11 and 24 after injec- tion. The correlation of mitochondrial membrane phospholipid localization and mtDNA3867 deletion rate between cardiac and skeletal muscle cells cells was analyzed using Spearman method. At the day 3 after injection, in both cardiac and skeletal muscle cells, mtDNA3867 deletion rate was significantly higher in experimental group than in control group (P<0.05), but the localization of mitochondrial membrane phospholipid showed no difference between two groups (P>0.05). At day 11 after injec- tion, the mtDNA3867 deletion rate of both cells in experimental group was increased to the peak level (P<0.05), and the impairment of mitochondrial membrane phospholipid localization of both cells also increased markedly in experimental group as compared with control group (P>0.05). At the day 24 after injection, the impairment of mitochondrial membrane phospholipid localization and mtDNA3867 deletion of both cells showed a recovery tendency, but still severer than those at the day 3 after injec- tion (P<0.05). The impairment of mitochondrial membrane phospholipid localization and mtDNA3867 deletion were consistent and synchronistic between cardiac and skeletal muscle cells, and showed good correlations (P<0.05). The impairment of mitochondria plays an important role in the patho- genesis of viral myocarditis, and the skeletal muscle cells might act as a peripheral 'window' to re- flect the mitochondrial damage of cardiac myocytes.

Effect of Astragalus Injection on Levels of Blood Selenium and Immunity Function in Children with Viral Myocarditis

Objective: To observe the effect of Astragalus Injection (AD on levels of blood selenium (Se) and cytokines, and T cellular immune function with viral myocarditis (VM) in children. Methods: Eighty children with VM were randomly divided into 2 groups. The control group consisted of 38 patients, to whom conventional therapy, including energy mixture, vitamin C and coenzyme Q10, etc. were given. The treated group (n = 42), to whom combination therapy of conventional therapy and Al were given. The levels of blood Se and cytokine, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and also evaluation of T lymphocyte subsets and cardiac function were observed. Results: The results showed that after treatment, the levels of blood Se were significantly higher (P<0.01), while IL-1,IL-6 and TNF-a were significantly lower (P<0.01) than those before treatment in the control group. The left ventricular end diameter (LVED) were significantly decreased (P<0.01), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were significantly increased than those before treatment in the treated group(P<0.01, P<0.05). T lymphocyte subsets got normalized (P<0.01), and compared with the control group, the difference was significant (P<0.01). Conclusion: Astragalus membranaceus possesses anti-viral effect, adjusts the balance of cytokine and T cellular immunity, and improves the clinical manifestation and cardiac function. It is an effective approach in treating viral myocarditis.

Comparison study of Mongolian milkvetch root and Indigowood treating murine viral myocarditis

Objective To investigate perfect therapeutic measure of Chinese traditional herbs through observing curative effect of single dose traditional Chinese medicine on murine viral myocarditis(VMC).Method Balb/C mice were inoculated intraperitoneally with diluted solution of coxsackievirus B3(CVB3) , and then were divided into three groups randomly: infected control group, Mongolian milkvetch root treated group; Indigowood treated group. The mice were put to death and their hearts were examined on day 3,5,7,10,14,21 post inoculated, and were stained with hemotoxylin and eosin(HE) to observe myocardial lesions and to estimate myocardial histopathological scores, simultaneously to separate virus from myocardium. In addition, we observed myocardial ultrastructure by electron microscopy on 7th day post inoculated. Result Compared with infected control group, myocardial histopathological scores of both Mongolian milkvetch root treated group from 5th day to 21st day post inoculated and Indigowood treated group on 5th day and 7th day post inoculated showed significant decrease(P< 0.05).Conclusion Mongolian milkvetch root could protect myocardial cells.

Observation on Therapeutic Effects of Shengmai Powder (生脉散)in Treating Acute Viral Myocarditis

Objective: To evaluate the clinical efficacy of Shengmai Powder (SMP, 生脉散) in treating a-cute viral myocarditis objectively. Methods: One hundred and twenty-four patients with acute viral myocarditis were randomized into the treated group (SMG, n = 64) and the control group(CG, n = 60 ). Such myo-cardial nutrient medicine as ATP, CoA , Vit-C, were given to both groups. And to the treated group, 40 ml of Shengmai Injection per day was given intravenously for 2 weeks, which was followed by oral intake of Shengmai granule, one package three times daily for another 2 weeks in total. The same anti-arrhythmia agents were applied to both groups, and no fructose-1, 6-diphosphate (FDP) for either. Semi-quantitative scoring method was adopted to observe such symptoms as chest stuffiness, palpitation and chest pain before treatment and four weeks after treatment. Meanwhile, EGG, dynamic ECG by Holter monitor, left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), serum neutralizing antibody of virus Coxsackie B, cardiac troponin I (cTnl) and cardiac troponin T (cTnT) were examined. Results: (1) Compared with the control group, more significant improvement was got in SMG in respects of chest stuffiness, palpitation, chest pain and arrhythmia (P<0.05 or P<0.01). (2) Negative converting rates of cTnl ,cTnT in the two groups were 59.46% vs35.48%, 68.75% vs42.31% respectively ( P<0. 05). (3) LVEDD before and after treatment in SMG was 52. 44 ± 3. 40 mm and 48. 81 ± 2. 23mm respectively, while that in the control group was 52. 31 ± 3. 74 mm and 49. 92 ± 2. 67mm respectively; LVEF before and after treatment in SMG was 60.67 ± 4. 62 % and 65. 02 ± 4. 16 % respectively, while that in the control group was 60.91 ± 4. 26 % and 63. 67 ± 3.17 % . There was obvious improvement in the two parameters in both groups, but the improvement in SMG was superior to that in the control group ( P<0. 05). Conclusion: SMP shows a good effect in improving clinical symptoms and signs, heart function, abnormal ECG and inflammatory injury indexes in patients with acute viral myocarditis.

STUDY ON PERSISTENT INFECTION OF COXSACKIEVIRUSGROUP B IN MURINE MODEL OF CHRONICVIRAL MYOCARDITIS

Objective To investigate the dynamic change of coxsackievirus B3 (CVB3) in murine model ofchronic myocarditis and revel the molecular mechanism of the persistent infection of the tirus.Methods Strand - specific RT- PCR(ssRT- PCR), quantitative RT- PCR (qRT - PCR) and multiplexRT- PCR(mRT- PCR). Results The positive strand of CVB3 RNA existed in heart tissue up to 3 monthsalthough its amount decreased by 103～4 folds from acute to chronic phase. The negative strand RNA for virusreplication kept its amount on la moleculars per gram heart tissue. Some conserved areas of virus RNA 5’NTRand 3’NTR were lost in chronic phase. Conclusion The virus kept replication during the whole phase ofmyocarditis and speeded down on chronic period in the status of persistent infection. That may be due to theterminal lose of CVB RNA.

Effect of Shengmal Powder(生脉散) on Symptoms and Markers of Inflammatory Damage of Patients with Acute Viral Myocarditis

Objective: To evaluate the efficacy of Sheng-mai Power (SMP) in treating acute viral myocarditis. Methods: 102 patients with acute viral myocarditis were randomized to SMS group (n = 52) and placebo control group (n = 50 ). Semiquantitative integral methods were taken to observe changes of clinical symptoms such as dyspnea, palpitation and chest pain after 4 weeks of treatment, simultaneously EKG, 24h Holter, concentration of serum cardiac troponin-I, cardiac troponin T and neutralizing antibody test to the Coxsackie B virus were determined. Results: Dyspnea improved much more obvious in SMP group than in the placebo

STUDY OF PERSISTENT VIRAL INFECTION IN AN ANIMAL MODEL OF VIRAL MYOCARDITIS BY PCR

Objective To study the role of persistent viral infection in the mechanism of viral myocarditis. Methods A mice model of CVB3m viral myocarditis wes made and the viral RNA in mice myocardium and whole bind sample wes tested by using polymerase chain reaction (PCR ) technique. The pathological changes in mice myocardium were determined. Results De day 3, the viral gene in whole bind and myocardium wes found, which portly became negative on day 8, but the change of myocardial anthology borne obvious. Although the bind specimens wers tested negatively on day 12, the viral gene in mice myocardium remained positive within 120d. Conclusion This study indicates that persistent viral infection plays a role in the pathogenesis of viral myocarditis.

Clinical value of high-dose VitC + immunoglobulin for the treatment of viral myocarditis in children

Objective: To study the clinical value of high-dose VitC + immunoglobulin for the treatment of viral myocarditis in children. Methods: Children who were diagnosed with viral myocarditis in the hospital between May 2014 and March 2017 were selected as the research subjects and divided into two groups by random number table, observation group received high-dose VitC+ immunoglobulin combined with conventional symptomatic and supportive treatment and control group received conventional symptomatic and supportive treatment. The serum levels of myocardial injury indexes, myocardial remodeling indexes and inflammatory response indexes were measured before treatment as well as at 1 week and 2 weeks after treatment. Results: 1 week and 2 weeks after treatment, serum CK-MB, cTnI, MDA, BNP, PINP, ICTP, MMP2, MMP9, TGFβ1, TNF-α, ICAM-1, MIP-1α and IL-17 levels of both groups of patients were significantly lower than those before treatment, and serum CK-MB, cTnI, MDA, BNP, PINP, ICTP, MMP2, MMP9, TGFβ1, TNF-α, ICAM-1, MIP-1α and IL-17 levels of observation group were lower than those of control group. Conclusion: High-dose VitC +immunoglobulin can reduce the myocardial damage and inhibit the myocardial remodeling and inflammatory response in children with viral myocarditis.

Correlation of peripheral blood IL-17A gene polymorphism with myocardial injury and MMPs/TIMPs balance in patients with viral myocarditis

Objective:To study the correlation of peripheral blood IL-17A gene polymorphism with myocardial injury and MMPs/TIMPs balance in patients with viral myocarditis.Methods:A total of 80 patients who were diagnosed with viral myocarditis in Dongguan Branch, Yan'an University Affiliated Hospital between September 2014 and September 2017 were selected as the VMC group of the research, and 100 healthy volunteers who received physical examination in Dongguan Branch, Yan'an University Affiliated Hospital during the same period were selected as the control group of the research. The peripheral blood was collected to determine the IL-17A gene rs2275913 locus polymorphism, and serum was collected to determine the contents of myocardial injury and MMPs/TIMPs indexes.Results: The proportion of IL-17A gene GG genotype of VMC group was lower than that of control group and the proportion of GA+AA genotype was higher than that of control group;serum IL-17, CK-MB, cTnI, sFas, MDA, PINP, ICTP, MMP2, MMP9, TIMP1 and TIMP2 contents of VMC group were significantly higher than those of control group, and serum IL-17, CK-MB, cTnI, sFas, MDA, PINP, ICTP, MMP2, MMP9, TIMP1 and TIMP2 contents of patients with GA+AA genotype in VMC group were higher than those of patients with GG genotype.Conclusion: The mutation of the allele G to A in the peripheral blood IL-17A gene rs2275913 locus of patients with viral myocarditis can aggravate myocardial injury and MMPs/TIMPs imbalance.

Effects of Shenmai Injection(参麦注射液)Combined with Meglumine Adenosine Cyclophosphate Injection on Cardiac Function and Peripheral Serum Levels of TNF-α,TGF-β1 and IFN-γ in Patients with Viral Myocarditis

Objective: To explore effects of Shenmai Injection(参麦注射液) combined with Meglumine Adenosine Cyclophosphate Injection on cardiac function and peripheral serum levels of tumor necrosis factor-α(TNF-α), transforming growth factor-β1(TGF-β1) and interferon-γ(IFN-γ) in patients with viral myocarditis.Methods: A total of 70 patients with viral myocarditis admitted in Cardiovascular Medicine Department of our hospital from June 2016 to June 2018 were selected and divided into a control group(treated with Meglumine Adenosine Cyclophosphate Injection) and an observation group(additionally treated with Shenmai Injection(参麦注射液) on the treatment basis of the control group) according to random number method, with 35 cases in each group.Before and after the treatment, cardiac functional indexes like cardiac index(CI), left ventricular ejection fraction(LVEF) and left ventricular shortening fraction(FS), serum levels of TNF-α, TGF-β1 and IFN-γ, clinical efficacy and adverse reactions occurred in the 2 groups were recorded and compared.Results: Therapeutic effective rate in the observation group was 88.57%, higher than 68.57% in the control group(P < 0.05).After the treatment, cardiac functional indexes like CI, LVEF and FS were higher than those in the control group(P < 0.05).After the treatment, the serum expression levels of TNF-α and TGF-β1 were lower than those in the control group(P < 0.05), while the serum expression level of IFN-γ was higher than that in the control group(P < 0.05).There was no statistically significant difference in the adverse reaction rates between the 2 groups(P > 0.05).Conclusion: The treatment of patients with viral myocarditis by Shenmai Injection(参麦注射液) combined with Meglumine Adenosine Cyclophosphate Injection is more effective, reducing inflammation and restoring cardiac function.

Study on the protective effect of adenosine cyclophosphate combined with vitamin C antiviral therapy on myocardial injury in children with viral myocarditis

Objective:TTo study the protective effect of adenosine cyclophosphate combined with vitamin C antiviral therapy on myocardial injury in children with viral myocarditis.Methods: 88 cases of children with viral myocarditis treated in Ningde Hospital of Traditional Chinese Medicine of Fujian University of Traditional Chinese Medicine between June 2014 and September 2016 were selected and randomly divided into the intervention group and the control group who received adenosine cyclophosphate combined with vitamin C antiviral therapy and conventional therapy respectively. Serum levels of myocardial injury indexes, antioxidant indexes and collagen metabolism indexes were determined.Results:1 week and 2 weeks after treatment, serum LDH, CK, CK-MB, ET-1, Ang-II, PICP and PINP contents of both groups were significantly lower than those before treatment while SOD, GSH-Px, CAT and HO-1 contents were significantly higher than those before treatment and serum LDH, CK, CK-MB, ET-1, Ang-II, PICP and PINP contents of intervention group were significantly lower than those of control group while SOD, GSH-Px, CAT and HO-1 contents were significantly higher than those of control group.Conclusion: Adenosine cyclophosphate combined with vitamin C therapy for viral myocarditis can reduce myocardial injury and improve collagen metabolism.

Experience in Treating Viral Myocarditis with Master Lei's Huoxue Decoction

Modem medical treatment of viral myocarditis by suppressing viral replication and improving cardiomyocyte metabolism has a good effect on the acute infectious period of viral myocarditis,but the curative rate is poor,especially the sequelae of viral myocarditis,which often lingers for years to decades.The use of traditional Chinese medicine can achieve a certain curative effect by promoting the positive and dispelling evil spirits as well as balancing yin and yang.After long-term observation,it is found to have clear eff ect on improving myocardial injury caused by viral myocarditis.

鸢尾素调节PD-1/PD-L1通路增强病毒性心肌炎小鼠的抗病毒免疫水平

目的:探讨鸢尾素调节程序性死亡因子-1(PD-1)/程序性死亡因子配体-1(PD-L1)通路增强病毒性心肌炎小鼠抗病毒免疫水平的作用。方法:取50只C57BL/6小鼠经腹腔接种柯萨奇病毒B3(CVB3)构建病毒性心肌炎小鼠模型,将建模成功小鼠随机分为模型组、鸢尾素低、中、高剂量组和阳性对照组,另取10只C57BL/6小鼠记为空白对照组。阳性对照组经腹腔注射给予10000 U/g干扰素,鸢尾素低、中、高剂量组经腹腔注射给予30、60、120μg/kg鸢尾素,空白对照组和阳性对照组均给予等量生理盐水,1次/d,共2周。HE染色观察小鼠心肌组织病理改变情况;空斑形成单位(PFU)法检测小鼠心肌组织的病毒滴度;流式细胞术检测小鼠外周血T淋巴细胞亚群(CD4^(+)T、CD8^(+)T、NK细胞)比例和CD4^(+)T/CD8^(+)T;ELISA检测小鼠心肌组织中炎症细胞因子IL-6、IL-17、TNF-α和IFN-γ水平;RT-qPCR检测小鼠T淋巴细胞PD-1及心肌组织PD-L1 mRNA表达;West?ern blot检测小鼠T淋巴细胞PD-1及心肌组织PD-L1蛋白表达。结果:与空白对照组相比,模型组小鼠心肌组织结构改变明显,有大量炎症细胞浸润和成片灶性坏死,心肌组织的病理积分、病毒滴度、炎症细胞因子IL-6、IL-17、TNF-α、IFN-γ水平和PDL1 mRNA及蛋白表达升高,外周血CD8^(+)T淋巴细胞比例及T淋巴细胞PD-1 mRNA及蛋白表达升高,外周血CD4^(+)T淋巴细胞、NK细胞比例及CD4^(+)T/CD8^(+)T降低,差异均有统计学意义(P<0.05);与模型组相比,阳性对照组和鸢尾素低、中、高剂量组心肌组织病变情况均有不同程度减轻,心肌组织的病理积分、病毒滴度、炎症细胞因子IL-6、IL-17、TNF-α、IFN-γ水平和PD-L1mRNA及蛋白表达降低,外周血CD8^(+)T淋巴细胞比例及T淋巴细胞PD-1 mRNA及蛋白表达降低,外周血CD4^(+)T淋巴细胞、NK细胞比例及CD4^(+)T/CD8^(+)T升高,其中鸢尾素作用呈剂量依赖性,差异均有统计学意义(P<0.05)。结论:鸢尾素具有增强病毒性心肌炎小鼠抗病毒免疫水平作用,推测是通过抑制PD-1/PD-L1通路激活,改善小鼠外周血T淋巴细胞亚群比例失调,提高机体免疫功能实现的。

病毒性心肌炎心房颤动的中医病机及治疗

病毒性心肌炎(VMC)多由感染嗜心肌性病毒,引起免疫炎症反应,从而导致心肌病变,而心房颤动是其重要的临床表现之一。中医辨证论治VMC有一定优势。VMC心房颤动的主要病机为正气不足,外感风邪,与湿、热、瘀、毒、虚等证候要素有关,“风惊悸”是对其最经典的概括。本文对VMC心房颤动急性期、缓解期、恢复期和慢性期四个疾病发展阶段分别以利湿、益气、养阴、温阳为治法,进行辨证论治,期待为VCM心房颤动的治疗提供理论支持。

静脉注射热毒宁联合玉屏风颗粒对邪毒犯心型儿童病毒性心肌炎的疗效

目的探讨静脉注射热毒宁注射液联合口服玉屏风颗粒对邪毒犯心型病毒性心肌炎(VMC)患儿的临床疗效及对炎症因子、心功能指标的影响。方法选择邪毒犯心型VMC患者147例,随机分为对照组50例、热毒宁组48例及热毒宁联合玉屏风颗粒组(联合组)49例,比较3组患儿的临床疗效、炎症因子变化及心功能指标。结果治疗1周后热毒宁组及联合组的治疗总有效率均优于对照组,热毒宁组及联合组的TNF、IL-6及IFN-γ等指标均明显低于对照组(P<0.01),联合组的IFN-γ低于热毒宁组。热毒宁组及联合组的CK-MB、BNP等指标均明显低于对照组,联合组的cTNI低于对照组及热毒宁组(P<0.01)。治疗两周后热毒宁组及联合组的治疗总有效率均明显优于对照组,联合组有效率优于热度宁组(P<0.01);热毒宁组及联合组的TNF、IL-6及IFN-γ等指标均明显低于对照组,联合组的TNF、IFN-γ等指标均明显低于热毒宁组(P<0.01)。热毒宁组及联合组的CK-MB、cTNI及BNP等指标均明显低于对照组,联合组的CK-MB、cTNI等指标均明显低于热毒宁组(P<0.01)。结论静脉注射热毒宁注射液佐以口服玉屏风颗粒能够有效提高邪毒犯心型儿童VMC的治疗有效率,改善其预后,这可能与其能够有效降低相关的炎症因子水平,降低心肌损伤标志物水平,修复心肌细胞有关。

血清miR-31、IL-22联合检测在儿童病毒性心肌炎诊断及预后评估中的价值

目的 研究血清微小RNA-31(miR-31)、白细胞介素-22(IL-22)在儿童病毒性心肌炎(VMC)诊断及预后评估中的价值。方法 选取2017年1月至2022年1月河南省儿童医院心血管内科收治的病毒性心肌炎患儿作为研究对象,将其命名为VMC组(n=106),另选同期在本院进行体检的健康儿童为对照组(n=70)。比较两组血清miR-31、IL-22、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)及心电图参数[QRS间期、PR间期]与超声心动图参数[左室射血分数(LVEF)、左心室短轴缩短率(LVFS)];在治疗结束后对VMC患儿随访1年,以随访期间发生恢复迁延、扩张性心肌病、遗留心律失常及患儿死亡等事件为预后不良,根据多因素Logistic回归分析VMC患儿预后不良的影响因素,并绘制ROC曲线分析血清miR-31、IL-22水平对VMC患儿诊断及预后不良评估的价值。结果 VMC组的血清miR-31、IL-22、CK-MB、cTnT水平及QRS间期、PR间期均高于对照组,差异有统计学意义(P<0.05),LVEF、LVFS均低于对照组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,miR-31水平高表达、IL-22水平升高、CK-MB水平升高、cTnT水平升高、QRS间期延长、PR间期延长、LVEF降低及LVFS降低均是VMC患儿预后不良的独立危险因素(P<0.05);ROC曲线分析显示,血清miR-31、IL-22水平二者联合检测诊断VMC的曲线下面积(AUC)为0.990,优于单一检测(P<0.05);血清miR-31、IL-22水平二者联合检测评估VMC患儿预后不良的曲线下面积(AUC)为0.919,优于单一检测(P<0.05)。结论 miR-31、IL-22在病毒性心肌炎患儿血清中高表达,可能成为儿童病毒性心肌炎诊断及预后评估的辅助诊断指标。

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

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。

磷酸肌酸钠联合维生素C治疗小儿病毒性心肌炎的效果

目的:观察磷酸肌酸钠联合维生素C治疗小儿病毒性心肌炎的效果。方法:选取2020年5月~2023年12月某院收治的病毒性心肌炎患儿106例,采用信封法分为对照组和观察组,每组53例。对照组给予利巴韦林注射液、辅酶Q10等常规治疗,观察组在常规治疗基础上给予磷酸肌酸钠联合维生素C治疗。比较治疗前后两组患儿心肌酶指标、心功能指标、单核细胞趋化蛋白-1(MCP-1)、高迁移率族蛋白B1(HMGB1)等因素水平,比较两组患儿临床疗效和安全性。结果:治疗后,两组患儿乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、羟丁酸脱氢酶(HBDH)、肌酸激酶(CK)、心肌肌钙蛋白I(cTnI)、MCP-1、HMGB1、正五聚蛋白-3(PTX-3)、细胞间黏附分子-1(ICAM-1)、超敏C反应蛋白(hs-CRP)、白介素-18(IL-18)均降低,且观察组低于对照组(P<0.05);治疗后,两组患儿左室射血分数(LVEF)、心脏指数(CI)及心室短轴缩短率(FS)均升高(P<0.05),但两组比较无统计学差异(P>0.05);观察组总有效率(90.57%)高于对照组(75.00%,P<0.05);两组患儿不良反应总发生率比较无统计学差异。结论:磷酸肌酸钠与维生素C联合治疗小儿病毒性心肌炎可改善心肌酶、MCP-1、HMGB1等相关指标水平,提高临床疗效,且不会增加不良反应。