皮质激素对病毒性心肌炎疗效及其不良反应预防的实验研究

目的 研究皮质激素对病毒性心肌炎(VM)的疗效与不良反应及预防不良反应的对策。方法 40只小鼠平均分为6组，每组40只，A组为正常对照组，B组单用激素组，C组单纯柯萨奇病毒(CVB)组，D组CVB 早期激素(CVB感染后3d用激素)组，E组CVB 早期激素 参麦注射液(SMI)组，F组CVB 后期激素(CVB感染后10d用激素)组。于感染后第3、7、10、14、21、30、40、50天，各组分别处死5只小鼠。检查心肌病理积分、病毒滴度和停留时间、心肌细胞凋亡率和坏死率。结果 CVB3感染小鼠早期用激素，心肌病理积分和细胞坏死率显著降低，对心肌细胞凋亡率无影响，但心肌内病毒滴度增高、停留时间延长；早期用激素加SMI可显著降低上述不良反应；后期用激素可提高疗效而无不良反应。结论 VM早期用激素可减轻心肌病变，降低心肌细胞坏死率，但可使病毒滴度升高，病毒在心肌内停留时间延长，如早期同时使用SMI可预防上述不良反应?

Experimental study on the effect of cortical steroid on viral myocarditis and the Shenmai injection on the prevention of undesirable reaction

Objective To confirm the effect and undesirable reaction of viral myocarditis (VM) treated with cortical steroid(CS) and the prevention measures to deal with undesirable reaction.Methods 240 mice were equally divided into 6 groups:group A as normal control,group B as CS group,group C as coxsackie virus B viral infection(CVB) group,group D as CVB3 CS early used(3 days after CVB infection),group E as CVB3 CS early used Shenmai injection(SMI),group F as CVB3 CS later used(10 days after infection).5 mice of each group were killed at the 3,7,10,14,21,30,40,50 day respectively after infection. Pathological scores, viral titer, viral retention time, cell apoptosis rate, cell necrosis rate of myocardium were examined.Results Myocardial cell pathological scores and necrosis rate were significantly lower in CS early used group than those in other groups,but the viral titer and viral retention time significantly higher in CS group than that in other groups.CS early used and SMI used in the same time could prevent this undesirable reaction.CS later used has therapeutic effect without the undesirable effect.Conclusions CS early used in the treatment of VM could improve the cardiomyopathy and reduce the necrosis rate of myocardial cell,but the viral titer and viral retention time were up.CS early used and SMI used in the same time could prevent the undesirable reaction mentioned above.