【摘要】：目的探討大劑量維生素C輔助免疫球蛋白對感染病毒性心肌炎(VMC)患者細胞間黏附因子-1(ICAM-1)、人巨噬細胞炎性蛋白1α(MIP-1α)及神經(jīng)生長因子(NGF)的影響。方法選取2015年5月-2016年5月醫(yī)院收治的54例原發(fā)性感染性VMC患者,隨機分為治療組及對照組,每組各27例;均予以吸氧、抗病毒、心肌代謝改善等常規(guī)治療,治療組予以大劑量維生素C聯(lián)合免疫球蛋白治療,對照組予以免疫球蛋白治療;檢測血清中ICAM-1、MIP-1α及NGF測定相關(guān)心肌酶譜指標,觀察臨床療效并進行評價。結(jié)果治療后,兩組血清ICAM-1、MIP-1α、NGF水平、心肌酶譜肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脫氫酶(LDH)水平較治療前均明顯降低(P0.05);且治療組ICAM-1、MIP-1α、NGF水平、心肌酶譜CK、CK-MB、LDH水平與對照組比較均明顯較低(P0.05);對照組總有效率為81.48%,低于治療組總有效率為96.30%(P0.05)。結(jié)論大劑量維生素C輔助免疫球蛋白對治療病毒感染性心肌炎療效顯著,安全性高,無顯著不良反應發(fā)生,且血清ICAM-1、MIP-1α及NGF作為新靶點,可為臨床診療提供新的思路,值得臨床的進一步推廣與探討。
[Abstract]:Objective to investigate the effects of high dose vitamin C adjuvant immunoglobulin on intercellular adhesion factor-1 (ICAM-1), human macrophage inflammatory protein 1 偽 (MIP-1 偽) and nerve growth factor (NGF) (NGF) in patients with viral myocarditis (VMC). Methods from May 2015 to May 2016, 54 patients with primary infectious VMC were randomly divided into treatment group (n = 27) and control group (n = 27). The treatment group was treated with high dose vitamin C combined with immunoglobulin, the control group was treated with immunoglobulin, and the serum ICAM-1,MIP-1 偽 and NGF were measured to determine the related myocardial enzymes, and the clinical efficacy was observed and evaluated. Results after treatment, the levels of serum ICAM-1,MIP-1 偽, NGF, myocardial creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) in both groups were significantly lower than those before treatment (P0.05), and the levels of ICAM-1,MIP-1 偽, NGF in treatment group were significantly lower than those before treatment (P0.05). Compared with the control group, the level of myocardial enzyme CK,CK-MB,LDH was significantly lower (P0.05), the total effective rate of the control group was 81.48, lower than that of the treatment group was 96.30% (P0.05). Conclusion High dose vitamin C immunoglobulin is effective and safe in the treatment of viral myocarditis, and serum ICAM-1,MIP-1 偽 and NGF as new targets can provide new ideas for clinical diagnosis and treatment. It is worthy of further clinical promotion and discussion.
【作者單位】： 臺州市中心醫(yī)院心內(nèi)科;
【基金】：浙江省醫(yī)藥衛(wèi)生科技計劃基金資助項目(JQ003224)
【分類號】：R542.21

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