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目的:观察乌司他丁治疗病毒性心肌炎的效果。方法:选择我科收治的急性病毒性心肌炎183例,根据治疗情况分为常规治疗组105例和乌司他丁组78例。常规治疗组给予卧床休息、营养心肌、抗病毒、治疗并发症等常规治疗,乌司他丁组在上述治疗基础上加用乌司他丁静脉滴注。比较两组入院时及治疗第3天、第7天、1个月时肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTn T)等心脏损伤标志物水平;分别于入院时、治疗1周和1个月后行超声检查,比较两组左心室射血分数(LVEF)、左心室舒张末内径(LVEDD)。结果:治疗第3天、第7天,乌司他丁组cTn T、CK-MB水平均显著或非常显著低于常规治疗组(P<0.05,P<0.01);治疗1个月后,两组cTn T、CK-MB水平均差异不显著(P>0.05)。治疗1周时,乌司他丁组LVEF值显著高于常规治疗组(P<0.05);治疗1个月后,乌司他丁组LVEF值显著高于常规治疗组(P<0.05),LVEDD值显著小于常规治疗组(P<0.05)。结论:在常规治疗基础上加用乌司他丁治疗病毒性心肌炎,可降低患者心脏损伤标志物水平,更好地恢复左心结构及功能。
Objective: To observe the effect of ulinastatin on viral myocarditis. Methods: 183 cases of acute viral myocarditis admitted to our department were divided into the conventional treatment group (105 cases) and ulinastatin group (78 cases). Conventional treatment group was given bed rest, myocardial nutrition, anti-virus, treatment of complications and other conventional treatment, ulinastatin group based on the above treatment with ulinastatin intravenous infusion. The levels of creatinine kinase (CK-MB), cardiac troponin (cTn T) and other cardiac injury markers were compared between the two groups on admission and on the third, seventh and first month of treatment. One week and one month after treatment, ultrasound examination was performed. Left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were compared between the two groups. Results: The cTn T and CK-MB levels in the ulinastatin group were significantly lower than those in the conventional treatment group (P <0.05, P <0.01) on the 3rd day and the 7th day after treatment. After 1 month, Group cTn T, CK-MB levels were not significantly different (P> 0.05). The LVEF of the ulinastatin group was significantly higher than that of the conventional treatment group at 1 week (P <0.05). After 1 month of treatment, the LVEF of the ulinastatin group was significantly higher than that of the conventional treatment group (P <0.05) Significantly less than the conventional treatment group (P <0.05). Conclusion: The addition of ulinastatin to viral myocarditis on the basis of routine treatment can reduce the level of cardiac injury markers in patients and restore the left ventricular structure and function better.