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丹参酮IIA磺酸钠联合曲美他嗪及左卡尼汀治疗急性病毒性心肌炎的临床疗效及其对血清TNF-α、IL-18和IL-35的影响

Clinical effects of tanshinone IIA sodium sulfonate combined with trimetazidine and levocarnitine in the treatment of AVMC and its effects on serum TNF-α, IL-18 and IL-35.

作者信息

Xu Pengliang, Ji Lei, Tian Shuang, Li Fumei

机构信息

Department of Pharmacy, Dongying City People's Hospital, Dongying, Shandong 257091, P.R. China.

Department of Spinal Surgery, Dongying City People's Hospital, Dongying, Shandong 257091, P.R. China.

出版信息

Exp Ther Med. 2018 Nov;16(5):4070-4074. doi: 10.3892/etm.2018.6671. Epub 2018 Aug 31.

Abstract

Clinical effects of tanshinone IIA sodium sulfonate combined with trimetazidine and levocarnitine in the treatment of acute viral myocarditis (AVMC) were investigated. Eighty-six patients with AVMC treated in Dongying City People's Hospital from August 2016 to July 2017 were selected and randomly divided into control group (n=43) and observation group (n=43). Patients in control group were treated with tanshinone IIA sodium sulfonate, while those in observation group were treated with trimetazidine and levocarnitine. The curative effect and improvement in clinical symptoms were compared between the two groups of patients, and enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of heart-type fatty acid-binding protein (H-FABP), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) in patients after treatment. Besides, the changes in levels of serum tumor necrosis factor-α (TNF-α), interleukin (IL)-18 and IL-35 were detected via ELISA. The total effective rate of treatment in observation group was significantly higher than that in control group (p<0.05). The improvement in clinical symptoms in observation group was significantly superior to that in control group (p<0.05). After treatment, levels of H-FABP, CK-MB and cTnI in observation group were obviously lower than those in control group (p<0.05). At 3, 5 and 7 days after treatment, the levels of TNF-α and IL-18 in both groups of patients were decreased compared with those before treatment, but the level of IL-35 was increased compared with that before treatment, and changes in observation group were more significant than those in control group (p<0.05). Tanshinone IIA sodium sulfonate combined with trimetazidine and levocarnitine has definite curative effects in the treatment of patients with AVMC, which can alleviate myocardial injury with higher safety, and effectively mitigate the inflammatory response in patients, so it is of great clinical significance.

摘要

探讨丹参酮ⅡA磺酸钠联合曲美他嗪及左卡尼汀治疗急性病毒性心肌炎(AVMC)的临床疗效。选取2016年8月至2017年7月在东营市人民医院治疗的86例AVMC患者,随机分为对照组(n = 43)和观察组(n = 43)。对照组患者采用丹参酮ⅡA磺酸钠治疗,观察组患者采用曲美他嗪及左卡尼汀治疗。比较两组患者的疗效及临床症状改善情况,采用酶联免疫吸附测定(ELISA)法检测治疗后患者心脏型脂肪酸结合蛋白(H-FABP)、肌酸激酶同工酶MB(CK-MB)及心肌肌钙蛋白I(cTnI)水平。此外,通过ELISA法检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-18及IL-35水平的变化。观察组治疗总有效率显著高于对照组(p < 0.05)。观察组临床症状改善情况显著优于对照组(p < 0.05)。治疗后,观察组H-FABP、CK-MB及cTnI水平明显低于对照组(p < 0.05)。治疗后3、5及7天,两组患者TNF-α及IL-18水平均较治疗前降低,但IL-35水平较治疗前升高,且观察组变化较对照组更显著(p < 0.05)。丹参酮ⅡA磺酸钠联合曲美他嗪及左卡尼汀治疗AVMC患者有确切疗效,可减轻心肌损伤,安全性较高,能有效减轻患者炎症反应,具有重要临床意义。

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