摘要
目的观察老年病毒性心肌炎（viralmyocarditis，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20mg，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。比较各组受试者人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。
Objective To observe the change of serum myocardial enzyme in patients with senile viral myocarditis （VM） tr=ated by trimetazidine, and analyze its effect on the prognosis, so as to provide r=fer=nce for clinical diagnosis and tr=atment of VM. Methods 114 cases of elderly patients with VM wer= randomly divided into observation group and control group, 57 cases for each group. All patients wer= tr=ated with conventional tr=atment, 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 wer= selected to normal group for r=fer=nce. Then the levels of serum myocardial enzymes and the LVEF wer= compar=d between all groups, and the levels of serum myocardial enzymes and the change of LVEF wer= observed 1, 2, 3, 4, 5, 6 weeks after tr=atment to investigate the effect of trimetazidine on the serum myocardial enzymes. Results The levels of CK and CK-MB of VM patients wer= higher than normal group, and the differ=nces wer= statistically significant （P 〈0.05）. The levels of CK, CK-MB of control group and observation group wer= significantly decr=ased, but the changes in observation group wer= mor= obvious, the differ=nces wer= statistically significant （P 〈0.05）. The total effective rate of control group was lower than observation group （84.2% vs 96.5%）, the differ=nce 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 differ=nce was not statistically significant （P 〉0.05）. The r=sults of Pearson corr=lation analysis showed that the CK （r= -0.780） and CK-MB （r=-0.801） had negative corr=lation with LVEF （P 〈 0.05）, while CK （r= -0.791） and CK-MB （r= -0.764） wer= negatively corr=lated with 1-year survival （P 〈 0.05）. Conclusion Trirhetazidine has positive significance to improve the prognosis of elderly patients with VM, and can help to pr=dict the 1-year survival and the change of LVEF combining detection of serum myocardial enzymes.
出处
《中国药物警戒》
2016年第8期456-459,共4页
Chinese Journal of Pharmacovigilance
关键词
老年
病毒性心肌炎
曲美他嗪
心肌酶谱
预后
elderly
viral myocarditis
trimetazidine
myocardial enzyme spectrum
prognosis
作者简介
孙玉胜，男，本科，副主任医师，内科临床。
