重症心肌炎患者经丙种球蛋白治疗的临床效果对其cTnT、CK―MB、BNP水平的影响.doc

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1、重症心肌炎患者经丙种球蛋白治疗的临床效果对其cTnTxCK—MBxBNP水平的影响［摘要］目的分析重症心肌炎患者应用丙种球蛋白治疗的疗效，以及丙种球蛋白对患者心肌损伤及心功能的影响。方法根据随机数字表法将2010年9月〜2015年9月陕西省宝鸡市中更陕院心血管内二科收治的40例急性重症心肌炎患者平均分为对照组和观察组，每组20例，对照组患者给予常规综合治疗，观察组患者另外应用丙种球蛋白进行静脉注射，对两组患者临床治疗效果、治疗前后的左心室内径(LV)、左心室射血分数(LVEF)、心肌肌钙蛋白(cT

2、nT)、肌酸激酶同工酶(CK-MB)和B型脑钠肽(BNP)的改善情况进行比较。结果观察组患者治疗后的临床总有效率和对照组比较明显较高(P0.05)；观察组患者治疗1个月后的LV平均值与对照组比较明显降低(P<0.05),LVEF值和对照组比较明显升高(P<0.05)o治疗1个月后，两组患者治疗的各项水平均显著低于治疗前水平，观察组患者各项水平的降低程度显著高于对照组患者(P<0.05)o结论丙种球蛋白治疗重症心肌炎的临床效果较好，可以冇效改善心功能和心肌损伤指标，建议推广应用。［关键词］重症心肌炎

3、;丙种球蛋白;LV；LVEF；cTnT；CK-MB；BNP［中图分类号］R542.2［文献标识码］A［文章编号］1673-7210(2016)08(a)-0061-05[Abstract]ObjectiveToanalysetheclinicaleffectandimpactonmyocardialdamageandheartfunctionofpatientswithseveremyocarditisbyusingthetreatmentofgammaglobulin.Methods40case

4、sofpatientswithacuteseveremyocarditisintheDepartmentofSecondDivisionofCardiovascularofBaojiCityChineseMedicineHospitalwereextractedfromSeptember2010toSeptember2015・Allpatientswererandomlydividedintoobservationgroupandcontrolgroup,with20casesineachgrou

5、p.Thepatientsinthecontrolgroupweretreatedwithroutinecomprehensivetreatment,whilethoseintheobservationgroupreceivedgammaglobulinforintravenousinjection.Theclinicaleffectandimprovementsituationofleftventriculardiameter(LV),leftventricularejectionfractio

6、n(LVEF),cardiactroponinT(cTnT),creatinekinaseisoenzyme(CK-MB),andBtypenatriureticpeptide(BNP)beforeandaftertreatmentwerecomparedbetweenthetwogroups.ResultsThetotaleffectiverateintheobservationgroupwassignifiedntlyhigherthanthatinthecontrolgroup(P0.05)

7、•TheLVmeanvalueafter1monthsoftreatmentintheobservationgroupwassignificantlylowerthanthatinthecontrolgroup,whiletheLVEI7valuewassignificantlyhigherthanthatinthecontrolgroup(P<0.05)・After1monthoftreatment,alllevelsofthetwogroupsweresignifiedfitlylowerth

8、anthosebeforetreatment,whi1ethe1evelsintheobservationgroupdecreasedsignificantly(P<0.05).ConiusionGammaglobulintreatmenthasgoodclinicaleffectofpatientswithseveremyocarditis,whichcaneffectivelyimprovethecardiacfunctionandmyocardialinjuryindex.I