CAJ | 학술논문

目的：观察丹参注射液对病毒性心肌炎的疗效及其抗氧自由基的作用。方法选择72例病毒性心肌炎患者，随机分为2组，传统组及丹参组。传统组采用能量合剂，1.6-二磷酸果糖改善心肌营养，卧床休息，重症用糖皮质激素，心律失常选用相应治疗；丹参组加用丹参注射液按每次5～15 mL，溶于5％葡萄糖中静滴，每天1次，2周为一疗程。观察2组临床表现、心肌酶谱的改变，前后对比观察其疗效。通过检测2组血清中超氧化物歧化酶（SOD）、丙二醛（MDA）等指标以了解丹参注射液的抗氧化作用。以36例健康者作对照组，检测3组血清中心肌肌钙蛋白（cTnT）、超敏C反应蛋白（hs-CRP）、肌酸激酶同工酶（CK-MB）和超氧化物歧化酶（SOD），评价其相关性。结果病毒性心肌炎组患者 SOD 的活性与健康组比较，差异有统计学意义（P＜0.01）。治疗后SOD 的活性明显升高（P＜0.01）。SOD与cTnT、hs-CRP 和 CK-MB水平呈负相关（P＜0.05）。丹参组临床疗效显著高于传统组（P＜0.05），治疗后患者心肌肌钙蛋白（cTnT）、超敏 C反应蛋白（hs-CRP）、肌酸激酶同工酶（CK-MB）水平显著降低（P＜0.05）且低于传统组治疗后；SOD活性显著高于传统组（P＜0.01）；MDA下降程度比传统组显著（P＜0.05）。结论氧自由基可能参与了病毒性心肌炎的发病过程，采用丹参注射液治疗病毒性心肌炎临床疗效满意，抗氧化作用可能是丹参注射液治疗病毒性心肌炎的重要机制之一。
목적：관찰단삼주사액대병독성심기염적료효급기항양자유기적작용。방법선택72례병독성심기염환자，수궤분위2조，전통조급단삼조。전통조채용능량합제，1.6-이린산과당개선심기영양，와상휴식，중증용당피질격소，심률실상선용상응치료；단삼조가용단삼주사액안매차5～15 mL，용우5％포도당중정적，매천1차，2주위일료정。관찰2조림상표현、심기매보적개변，전후대비관찰기료효。통과검측2조혈청중초양화물기화매（SOD）、병이철（MDA）등지표이료해단삼주사액적항양화작용。이36례건강자작대조조，검측3조혈청중심기기개단백（cTnT）、초민C반응단백（hs-CRP）、기산격매동공매（CK-MB）화초양화물기화매（SOD），평개기상관성。결과병독성심기염조환자 SOD 적활성여건강조비교，차이유통계학의의（P＜0.01）。치료후SOD 적활성명현승고（P＜0.01）。SOD여cTnT、hs-CRP 화 CK-MB수평정부상관（P＜0.05）。단삼조림상료효현저고우전통조（P＜0.05），치료후환자심기기개단백（cTnT）、초민 C반응단백（hs-CRP）、기산격매동공매（CK-MB）수평현저강저（P＜0.05）차저우전통조치료후；SOD활성현저고우전통조（P＜0.01）；MDA하강정도비전통조현저（P＜0.05）。결론양자유기가능삼여료병독성심기염적발병과정，채용단삼주사액치료병독성심기염림상료효만의，항양화작용가능시단삼주사액치료병독성심기염적중요궤제지일。
Objective To observe the effect of salvia miltiorrhiza injection on antioxygen free radicals and its efficacy on viral myocarditis. Methods 72 cases of patients with viral myocarditis were randomly divided into two groups.The traditional group with energy mixture,1.6-diphosphate fructose improving myocardial nutrition,bed rest,intensive use of glucocorticoid,selected the appropriate treatment for arrhythmia;salvia miltiorrhiza group in the control group treatment combined with salvia miltiorrhiza injection of 5 ~15 mL each time,dissolved in 5%glucose intravenous drip,once a day,2 weeks as a course of treatment.To observe two groups of manifestation,the change of myocardial enzyme spectrum and the comparative efficacy before and after the treatment.Through the detection of the treatment group and the control group of serum superoxide dismutase (SOD ), malondialdehyde (MDA)and other indicators to understand the antioxidant effect of salvia miltiorrhiza injection.36 healthy children were taken as control group,detected cardiac troponin (cTnT),high sensitive C reactive protein (hs-CRP),creatine kinase isoenzyme MB (CK-MB)and SOD in three groups,their correlations were evaluated as well.Results Compared with healthy children,the activity of SOD in salvia miltiorrhiza group was statistically significant (P<0.01).The activity of SOD increased significantly (P<0.01).SOD was negatively correlated with cTnT,hs-CRP and CK-MB levels (P<0.05 ).The curative effect of salvia miltiorrhiza group were significantly higher than that of the control group.CTnT,hs-CRP and CK-MB levels decreased significantly after treatment (P<0.05 ),which in salvia miltiorrhiza group decreased significantly than that of the control group.SOD activity increased value was higher than the traditional group (P<0.01 );the decrease in MDA was obvious than that of the traditional group (P<0.05 ).Conclusion Oxygen free radicals are involved in the pathogenesis of viral myocarditis;the efficacy of salvia miltiorrhiza injection in the treatment of viral myocarditis is proved of curative effect;antioxidant effect may be an important mechanism of salvia miltirrhiza injection in the treatment of viral myocarditis.