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磷酸肌酸钠和/或维生素 C 治疗小儿病毒性心肌炎的临床疗效:Meta 分析。

Clinical Efficacy of Creatine Phosphate Sodium and/or Vitamin C in the Treatment of Children with Viral Myocarditis: A Meta-Analysis.

机构信息

Department of Pediatrics, General Hospital of Northern Theater Command, No. 5 Guangrong Street, Heping District, Shenyang 110812, China.

出版信息

Comput Math Methods Med. 2022 Aug 10;2022:3840891. doi: 10.1155/2022/3840891. eCollection 2022.

Abstract

BACKGROUND

This study performed a meta-analysis to explore the clinical efficacy of creatine phosphate sodium (CPS) and/or vitamin C for viral myocarditis (VMC) in children, to provide guidance for its clinical treatment.

METHODS

A literature search was performed on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang databases to obtain published clinical randomized controlled trials (RCTs) on CPS and/or vitamin C for VMC in children, with a time span from 2013 to 2022. Relevant data was extracted and meta-analysis was performed using the statistical software Stata 16.0.

RESULTS

A total of 723 studies were retrieved and 19 studies were finally included for meta-analysis, with a total of 1,957 patients. The meta-analysis results showed that the observation group (conventional treatment + CPS and/or vitamin C) was superior to the control group (conventional treatment alone) in treatment effective rate (OR = 3.60, 95% CI (2.55, 5.07), and < 0.001). Additionally, the observation group had lower levels of cardiac troponin-I (SMD = - 2.63, 95% CI (- 3.51, - 1.76), and < 0.001), creatine kinase isoenzyme (SMD = -2.78, 95% CI (- 3.53, - 2.03), and < 0.001), lactate dehydrogenase (SMD = -1.95, 95% CI (- 2.49, - 1.42), and < 0.001), aspartate aminotransferase (SMD = -0.87, 95% CI (- 1.84, 0.09), and = 0.076), tumor necrosis factor- (SMD = -3.90, 95% CI (- 4.47, - 3.06), and < 0.001), and higher superoxide dismutase levels (SMD = 2.48, 95% CI (1.64, 3.33), and < 0.001). Except aspartate aminotransferase, there were significant differences between the two groups in the other parameters.

CONCLUSION

CPS and/or vitamin C treatment could greatly improve the treatment, protect myocardial function, and relieve inflammatory response in children with VMC.

摘要

背景

本研究进行了荟萃分析,以探讨磷酸肌酸钠(CPS)和/或维生素 C 治疗儿童病毒性心肌炎(VMC)的临床疗效,为其临床治疗提供指导。

方法

在 PubMed、Web of Science、Embase、中国知网和万方数据库中检索 2013 年至 2022 年发表的关于 CPS 和/或维生素 C 治疗儿童 VMC 的临床随机对照试验(RCT),提取相关数据,并使用统计软件 Stata 16.0 进行荟萃分析。

结果

共检索到 723 篇研究,最终纳入 19 项研究进行荟萃分析,共 1957 例患者。荟萃分析结果显示,观察组(常规治疗+CPS 和/或维生素 C)治疗有效率优于对照组(常规治疗)(OR=3.60,95%CI(2.55,5.07), <0.001)。此外,观察组的肌钙蛋白 I(SMD=-2.63,95%CI(-3.51,-1.76), <0.001)、肌酸激酶同工酶(SMD=-2.78,95%CI(-3.53,-2.03), <0.001)、乳酸脱氢酶(SMD=-1.95,95%CI(-2.49,-1.42), <0.001)、天冬氨酸转氨酶(SMD=-0.87,95%CI(-1.84,0.09), =0.076)、肿瘤坏死因子-α(SMD=-3.90,95%CI(-4.47,-3.06), <0.001)水平较低,超氧化物歧化酶(SMD=2.48,95%CI(1.64,3.33), <0.001)水平较高。除天冬氨酸转氨酶外,两组在其他参数上均有显著差异。

结论

CPS 和/或维生素 C 治疗可显著提高儿童 VMC 的治疗效果,保护心肌功能,缓解炎症反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c345/9385374/d5a27656514d/CMMM2022-3840891.001.jpg

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