Abstract:

Objective　To explore the effect of cyclic adenosine monophosphate and coenzyme Q10 in the clinical treatment of patients with viral myocarditis. Methods　Ninety-five patients with viral myocarditis who were treated in Liaocheng Second People's Hospital from April 2020 to April 2022 were selected as the study objects. They were divided into a control group (48 cases) and a combination group (47 cases) by the computer random number table method. There were 27 males and 21 females in the control group who were 20-50 (35.21±7.04) years old. There were 22 males and 25 females in the combination group who were 20-45 (33.74±6.75) years old. The control group were treated with cyclic adenosine monophosphate and conventional therapy; and the combination group were treated with cyclic adenosine monophosphate, coenzyme Q10, and conventional therapy. The clinical efficacies, levels of oxidative stress indicators and myocardial injury markers, and adverse drug reactions of the two groups were compared and analyzed. t and χ² tests were applied. Results　The efficacy in the combination group was better than that in the control group [97.87% (46/47) vs. 83.33% (40/48)], with a statistical difference (P<0.05). After the treatment, the levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) were higher and the level of malondialdehyde (MDA) was lower than those before the treatment in both groups (all P<0.05). The levels of SOD, GSH-Px, CAT, and MDA in the combination group were better than those in the control group [(84.31±12.04) IU/L vs. (78.65±11.24) IU/L, (95.47±11.93) U/L vs. (87.62±10.95) IU/L, (75.43±8.38) U/L vs. (67.21±7.47) U/L, and (3.45±0.69) μmol/L vs. (4.37±0.87) μmol/L], with statistical differences (all P<0.05). After the treatment, the levels of C-reactive protein (CRP), cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), and lactate dehydrogenase (LDH) were lower than those before the treatment in both groups (all P<0.05). After the treatment, the levels of CRP, cTnI, CK-MB, and LDH in the combination group were significantly lower than those in the control group [(1.65±0.33) mg/L vs. (2.14±0.43) mg/L, (0.31±0.07) μg/L vs. (0.37±0.09) μg/L, (12.37±2.47) U/L vs. (15.41±3.08) U/L, and (112.73±12.53) IU/L vs. (142.84±15.87) IU/L], with statistical differences (all P<0.05). There was no statistical difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusions　The combination of cyclic adenosine monophosphate and coenzyme Q10 in the clinical treatment of patients with viral myocarditis can significantly improve the clinical efficacy, the oxidative stress reaction, and myocardial injury, and reduce the adverse reactions. It is safe and reliable.

Key words:

Viral myocarditis, Cyclic adenosine phosphate, Coenzyme Q10, Oxidative stress, Myocardial damage

摘要：

目的　探究环磷腺苷联合辅酶Q10应用于病毒性心肌炎患者临床治疗中的效果。方法　选取2020年4月至2022年4月在聊城市第二人民医院进行治疗的病毒性心肌炎患者95例为本次研究对象，采用电脑随机数字表法将其分为对照组与联合组。对照组48例，其中男27例，女21例，年龄20～50（35.21±7.04）岁；联合组47例，其中男22例，女25例，年龄为20～45（33.74±6.75）岁。对照组予以常规疗法加环磷腺苷治疗，联合组予以常规疗法加环磷腺苷和辅酶Q10治疗。比较两组患者的临床疗效、氧化应激指标水平、心肌损伤标志物水平及用药不良反应，采用t检验、χ²检验进行统计分析。结果　联合组有效率为97.87%（46/47），对照组为83.33%（40/48），两组比较，差异有统计学意义（P<0.05）。治疗后，两组超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、过氧化氢酶（CAT）水平均高于治疗前，丙二醛（MDA）水平均低于治疗前（均P<0.05）；治疗后，联合组SOD为（84.31±12.04）IU/L、GSH-Px为（95.47±11.93）U/L、CAT为（75.43±8.38）U/L，均明显高于对照组［SOD为（78.65±11.24）IU/L、GSH-Px为（87.62±10.95）U/L、CAT为（67.21±7.47）U/L］，联合组MDA为（3.45±0.69）μmol/L，明显低于对照组［（4.37±0.87）μmol/L］，两组比较，差异均有统计学意义（P<0.05）。治疗后，两组C反应蛋白（CRP）、心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）水平均低于治疗前（均P<0.05）；治疗后，联合组CRP为（1.65±0.33）mg/L、cTnI为（0.31±0.07）μg/L、CK-MB为（12.37±2.47）U/L、LDH为（112.73±12.53）IU/L，均明显低于对照组［CRP（2.14±0.43）mg/L、cTnI（0.37±0.09）μg/L、CK-MB（15.41±3.08）U/L、LDH（142.84±15.87）IU/L］，两组比较，差异均有统计学意义（均P<0.05）。两组不良反应比较，差异无统计学意义（P>0.05）。结论　环磷腺苷联合辅酶Q10治疗病毒性心肌炎，能明显提高患者的临床疗效，改善氧化应激反应及心肌损伤，患者不良反应较少，安全可靠。

关键词:

病毒性心肌炎, 环磷腺苷, 辅酶Q10, 氧化应激, 心肌损伤