老年病毒性心肌炎患者曲美他嗪治疗期间血清心肌酶谱的变化及预后

摘要/Abstract

摘要： 目的观察老年病毒性心肌炎（viral myocarditis,VM）患者接受曲美他嗪治疗期间血清心肌酶谱的变化及对预后的影响,为老年VM的临床诊治。方法选取我院2013年9月~2014年9月收治的114例老年VM患者,按照随机数字表法分为观察组及对照组,各57例,均给予常规VM治疗,观察组在此基础上加用曲美他嗪口服治疗,每日3次,每次20 mg,持续6周。并选取同期50例健康体检者,纳入正常组以供对照参考。比较各组受试者入组后心肌酶谱水平和左室射血分数（LVEF）,并观察组及对照组治疗1、2、3、4、5、6周后心肌酶谱水平及LVEF变化,观察曲美他嗪对患者心肌酶谱水平的影响。结果 VM患者CK、CK-MB显著高于正常组,其LVEF显著低于正常组,差异有统计学意义（P<0.05）。对照组、观察组VM患者治疗后CK、CK-MB均显著降低,LVEF均显著升高,观察组变化更为明显,差异有统计学意义（P<0.05）。对照组临床总有效率为84.2%,显著低于观察组的96.5%,差异有统计学意义（P<0.05）。对照组1年生存率为93.0%（53/57）,观察组1年生存率为98.2%（56/57）,两组患者1年生存率比较,差异无统计学意义（P>0.05）;Pearson相关分析示,CK（r=-0.780）、CK-MB（r=-0.801）与LVEF均呈负相关（P<0.05）,CK（r=-0.791）、CK-MB（r=-0.764）与患者1年生存率亦呈负相关（P<0.05）。结论曲美他嗪对老年VM患者预后的改善具有积极意义,联合检测血清心肌酶谱能够预测患者LVEF及1年生存率变化。

关键词: 老年, 病毒性心肌炎, 曲美他嗪, 心肌酶谱, 预后

Abstract: Objective To observe the change of serum myocardial enzyme in patients with senile viral myocarditis (VM) treated by trimetazidine, and analyze its effect on the prognosis, so as to provide reference for clinical diagnosis and treatment of VM. Methods 114 cases of elderly patients with VM were randomly divided into observation group and control group, 57 cases for each group. All patients were treated with conventional treatment, while trimetazidine 20 mg, tid, was added to the patients in observation group for 6 weeks. In the same period, 50 cases of healthy people were selected to normal group for reference. Then the levels of serum myocardial enzymes and the LVEF were compared between all groups, and the levels of serum myocardial enzymes and the change of LVEF were observed 1, 2, 3, 4, 5, 6 weeks after treatment to investigate the effect of trimetazidine on the serum myocardial enzymes. Results The levels of CK and CK-MB of VM patients were higher than normal group, and the differences were statistically significant (P <0.05). The levels of CK, CK-MB of control group and observation group were significantly decreased, but the changes in observation group were more obvious, the differences were statistically significant (P <0.05). The total effective rate of control group was lower than observation group (84.2% vs 96.5%), the difference was statistically significant (P <0.05). The 1 year survival rate was 93.0% (53/57) in control group,and 98.2% (56/57) in observation group, the difference was not statistically significant (P >0.05). The results of Pearson correlation analysis showed that the CK (r= -0.780) and CK-MB (r=-0.801) had negative correlation with LVEF (P<0.05), while CK (r= -0.791) and CK-MB (r= -0.764) were negatively correlated with 1-year survival (P<0.05). Conclusion Trimetazidine has positive significance to improve the prognosis of elderly patients with VM, and can help to predict the 1-year survival and the change of LVEF combining detection of serum myocardial enzymes.

Key words: elderly, viral myocarditis, trimetazidine, myocardial enzyme spectrum, prognosis

中图分类号:

R972

孙玉胜. 老年病毒性心肌炎患者曲美他嗪治疗期间血清心肌酶谱的变化及预后[J]. 中国药物警戒, 2016, 13(8): 456-459.

SUN, Yu-sheng. Changes of Serum Myocardial Enzyme Spectrum and Prognosis in Elderly Patients with Acute Myocarditis Treated by Trimetazidine[J]. Chinese Journal of Pharmacovigilance, 2016, 13(8): 456-459.

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