METHODS: We enrolled 121 young patients with VMC who were admitted in our hospital from February 2017 to September 2018, and divided them into two groups as follows: study group (62 patients, IVIG + CP + routine treatment), and control group (59 patients, conventional treatment). Patient\'s baseline data, including gender, age, disease course, etiology, cardiac function classification, and severity, were collected. Ejection fraction (EF), fractional shortening (FS), and mitral ratio of peak early to late diastolic filling velocity (E/A ratio) before and after treatment were recorded. These changes include the lactate dehydrogenase, creatine kinase (CK), aspartate aminotransferase, creatine kinase isoenzyme (CK-MB), and cardiac troponin I (CTnI). Furthermore, the changes in immune factors such as CD3+, CD4+, and CD8+ before and after the treatment were determined.
RESULTS: The study group had a significantly higher response rate than the control group (P < 0.05). After treatment, the ejection fraction, fractional shortening, and mitral ratio of peak early-to-late diastolic filling velocity were more significantly improved in the study group than in the control group (P < 0.05). The electrocardiogram (ECG) results of the study group were also significantly better than those of the control group (P < 0.05). The levels of lactate dehydrogenase (LDH), creatine kinase (CK), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), and cardiac troponin I (CTnI) in the study group were all significantly better than those in the control group (P < 0.05). Symptom recuperation, cardiac function recovery, and ECG and myocardial enzyme normalization were significantly faster in the study group than those in the control group (P < 0.05). The immune factor levels in the study group also significantly improved compared with those before the treatment (P < 0.05). Meanwhile, the adverse reactions in both groups showed no differences (P < 0.05).
CONCLUSIONS: IVIG combined with CP exhibited better clinical effects and effectively boosted the immune system of patients with VMC.
方法:我们选取我院2017年2月至2018年9月收治的121例年轻VMC患者,将其分为两组:IVIG+CP+常规治疗),对照组(59例,常规治疗)。患者的基线数据,包括性别,年龄,病程,病因学,心功能分类,和严重性,被收集。射血分数(EF),分数缩短(FS),记录治疗前后二尖瓣舒张早期与晚期充盈速度峰值比值(E/A比值)。这些变化包括乳酸脱氢酶,肌酸激酶(CK),天冬氨酸转氨酶,肌酸激酶同工酶(CK-MB),和心肌肌钙蛋白I(CTnI)。此外,免疫因子如CD3+的变化,CD4+,治疗前后测定CD8+。
结果:研究组有效率明显高于对照组(P<0.05)。治疗后,射血分数,分数缩短,与对照组相比,研究组舒张早期至晚期的二尖瓣峰值充盈速度比值改善更为显著(P<0.05)。研究组的心电图结果也明显优于对照组(P<0.05)。乳酸脱氢酶(LDH)的水平,肌酸激酶(CK),天冬氨酸转氨酶(AST),肌酸激酶同工酶(CK-MB),研究组心肌肌钙蛋白I(CTnI)均优于对照组(P<0.05)。症状恢复,心功能恢复,研究组心电图和心肌酶复常均明显快于对照组(P<0.05)。研究组患者的免疫因子水平较治疗前也有明显改善(P<0.05)。同时,两组不良反应比较差异无统计学意义(P>0.05)。
结论:IVIG联合CP具有较好的临床疗效,可有效增强VMC患者的免疫系统。