人免疫球蛋白联合糖皮质激素治疗急性重症病毒性心肌炎的效果及对IL-12水平的影响
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摘要
目的评价人免疫球蛋白联合糖皮质激素(GCs)治疗急性重症病毒性心肌炎(ASVMC)的效果及对IL-12水平的影响。方法回顾性分析我院2016年1月至2018年6月收治的82例ASVMC患者的临床资料,根据治疗方案的不同将患者分为对照组(41例,给予GCs治疗)和观察组(41例,给予静注人免疫球蛋白联合GCs治疗)。比较两组的治疗效果。结果观察组治疗总有效率显著高于对照组(P<0.05)。治疗14、30 d后,两组血清IL-12水平均明显升高,且观察组均高于对照组(P<0.05);治疗30 d后,两组CK-MB和cTnI水平均明显降低,且观察组低于对照组(P<0.05)。结论人免疫球蛋白联合GCs治疗ASVMC效果显著,可增加IL-12水平,减轻心肌损害。
Objective To evaluate effect of human immunoglobulin combined with glucocorticoid(GCs) in acute severe viral myocarditis(ASVMC) and its influence on IL-12 level. Methods The clinical data of 82 patients with ASVMC admitted in our hospital from January 2016 to June 2018 were retrospectively analyzed. Patients were divided into control group(41 cases, treated with GCs) and observation group(41 cases, treated with intravenous human immunoglobulin combined with GCs) according to the different treatment methods. The therapeutic effects were compared between the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05). After 14 and 30 days of treatment, the levels of IL-12 of the two groups increased significantly, and those in the observation group were higher than the control group(P<0.05). After 30 days of treatment, the levels of CKMB and cTnI in the two groups decreased significantly, and those in the observation group were lower than the control group(P <0.05). Conclusion Intravenous human immunoglobulin combined with GCs has a significant effect in the treatment of ASVMC, it can increase the level of IL-12 and alleviate myocardial damage.
Objective To evaluate effect of human immunoglobulin combined with glucocorticoid(GCs) in acute severe viral myocarditis(ASVMC) and its influence on IL-12 level. Methods The clinical data of 82 patients with ASVMC admitted in our hospital from January 2016 to June 2018 were retrospectively analyzed. Patients were divided into control group(41 cases, treated with GCs) and observation group(41 cases, treated with intravenous human immunoglobulin combined with GCs) according to the different treatment methods. The therapeutic effects were compared between the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05). After 14 and 30 days of treatment, the levels of IL-12 of the two groups increased significantly, and those in the observation group were higher than the control group(P<0.05). After 30 days of treatment, the levels of CKMB and cTnI in the two groups decreased significantly, and those in the observation group were lower than the control group(P <0.05). Conclusion Intravenous human immunoglobulin combined with GCs has a significant effect in the treatment of ASVMC, it can increase the level of IL-12 and alleviate myocardial damage.
引文
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[2]刘颖.62例重症病毒性心肌炎的临床分析[J].临床内科杂志,2013,30(12):814-815.
[3]SHAUER A,GOTSMAN I,KEREN A,et al.Acute viral myocarditis:current concepts in diagnosis and treatment[J].Isr Med Assoc J,2013,15(3):180-185.
[4]张士辉,丁涛.丙种球蛋白治疗小儿急性病毒性心肌炎合并完全性房室传导阻滞的临床观察[J].心脑血管病防治,2016,16(4):273-275.
[5]段国富.丙种球蛋白治疗病毒性心肌炎的临床观察[J].中国医学创新,2010,27(27):109-110.
[6]王薇,杜波,张林,等.静注丙种球蛋白联合糖皮质激素治疗急性重症病毒性心肌炎的临床研究[J].泰山医学院学报,2016,37(11):1230-1232.
[7]李凡,熊维建.糖皮质激素致病毒性心肌炎1例[J].第三军医大学学报,2014,36(11):1223.
[8]DALAKAS MC.Intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases:present status and practical therapeutic guidelines[J].Muscle Nerve,2015,22(11):1479-1497.
[9]周鹏.白细胞介素-12生物学作用的研究进展[J].中国生物制品学杂志,2017,30(3):325-328.