参麦注射液对病毒性心肌炎患者的疗效及外周血NLRP3炎性小体的影响

目的探讨参麦注射液对病毒性心肌炎患者的临床疗效及外周血核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎性小体表达的影响。方法以2015年1月-2019年1月入院的140例病毒性心肌炎患者为研究对象,根据随机数字表法将患者分为观察组(70例)和对照组(70例),对照组给予常规治疗,观察组在对照组基础上给予参麦注射液,疗程为2周。比较两组患者临床疗效及治疗前后外周血单核细胞(PBMCs)中NLRP3、半胱氨酸蛋白酶1(Caspase-1)mRNA及蛋白表达水平;相关炎性细胞因子白细胞介素-1β(Interleukin-1β,IL-1β)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平;心肌损伤标志物肌酸激酶同工酶(Crea鄄tine kinade MB,CKMB)、心肌肌钙蛋白I(Cardiac troponin I,cTnI)、肌红蛋白(Myoglobin,MYO)]水平;统计两组患者不良反应发生情况。结果与治疗前比较,两组治疗后外周血NLRP3、Caspase-1 mRNA及蛋白表达水平明显降低(P<0.05),其中观察组上述指标降低更明显(P<0.05);观察组治疗后外周血IL-1β和TNF-α水平显著低于对照组(P<0.05);观察组治疗后血清心肌损伤标志物CKMB、cTnI及MYO水平显著低于对照组(P<0.05);治疗后,观察组总有效率(91.4%)显著高于对照组(78.6%);而不良反应比较,两组差异无统计学意义(P>0.05)。结论参麦注射液可显著降低病毒性心肌炎患者外周血NLRP3炎性小体水平,发挥显著抗炎作用,从而提高临床疗效。

Clinical Efficacy of Shenmai Injection in Patients with Viral Myocarditis and Effects on NLRP3 Inflammasome in Peripheral Blood

Objective To explore the clinical effect of Shenmai Injection on patients with viral myocarditis and the effects on expression of pertipheral blood nucleotide-binding oligomeric domain-like receptor protein 3(NLRP3) inflammasome corpuscles.Methods A total of 140 patients with viral myocarditis were enrolled from January 2015 to January 2019 in our hospital. According to the random number table, the patients were divided into an observation group(70 cases) and a control group(70 cases). The control group received conventional treatment and the observation group received the Shenmai Injection on the basis of the control group for 2 weeks. The clinical efficacy and the expression levels of NLRP3, cysteine protease 1(Caspase-1) m RNA and protein in peripheral blood mononuclear cells(PBMCs), related inflammatory cytokines Interleukin-1β(IL-1β), Tumor necrosis factor-α(TNF-α)] levels, myocardial injury markers creatine kinase isokines Creatinine kinade MB(CKMB), cardiac troponin I(cTnI), myoglobin(MYO)] levels before and after treatment between the 2 groups of patients were compared. The adverse reactions of the 2 group were counted. Results Compared with before treatment, the levels of NLRP3 and Caspase-1 mRNA and protein expression in peripheral blood of the 2 groups were significantly decreased(P <0.05), and the decreased degree of the above indicators were more significant in the observation group(P<0.05). The levels of IL-1β and TNF-α in peripheral blood of the observation group were significantly lower than that of the control group(P<0.05). The levels of CKMB cTnI, and MYO in the observation group after treatment were significantly lower than those in the control group(P<0.05);After treatment, the total effective rate of the observation group was significantly higher than that of the control group(P <0.05), however, there was no significant difference in adverse reactions between the 2 groups(P>0.05). Conclusion Shenmai Injection can significantly reduce the level of NLRP3 inflammasome in peripheral blood of viral myocarditis, exerting anti-inflammatory and improving clinical efficacy.