目的 探討免疫球蛋白聯(lián)合去乙酰毛花苷注射液治療老年擴(kuò)張型心肌病的臨床療效。方法 選取2010年1月—2014年12月榆林市第一醫(yī)院心血管內(nèi)科收治的老年擴(kuò)張型心肌病患者200例,隨機(jī)分為對(duì)照組和治療組,每組各100例。兩組患者均接受利尿劑等常規(guī)基礎(chǔ)治療。對(duì)照組患者靜脈滴注去乙酰毛花苷注射液,0.5 mg/次,2次/d;治療組在對(duì)照組基礎(chǔ)上靜脈滴注靜注人免疫球蛋白,400 mg/d。兩組均連續(xù)治療4周。觀察兩組的臨床療效,同時(shí)比較兩組治療前后左心室射血分?jǐn)?shù)(LVEF)、舒張?jiān)缙谘鞣逯邓俣?EPFV)、充盈早期速率/晚期速率(E/A)、舒張晚期血流峰值速度(APFV)、左心室收縮末期容積(LVESV)、左心室質(zhì)量(LV)、左心室舒張末期容積(LVEDV)、心胸比(CTR)、IgG抗體的變化情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為69.00%、85.00%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。治療后,兩組患者LVEF、E/A、EPFV顯著升高,APFV、LVESV、LVEDV、LV、CTR、IgG抗體均顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。結(jié)論 免疫球蛋白聯(lián)合去乙酰毛花苷注射液治療老年擴(kuò)張型心肌病具有較好的臨床療效,可顯著改善患者的心功能,降低IgG抗體水平,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the curative effect of human immunoglobulin combined with Deslanoside Injection in treatment of elder dilated cardiomyopathy. Methods Patients (200 cases) with dilated cardiomyopathy in Department of Cardiovascular Internal Medicine of the First Hospital of Yulin from January 2010 to December 2014 were randomly divided into control and treatment groups, and each group had 100 cases. Patients in two groups were given regular basic treatment such as diuretics. The patients in the control group were iv administered with Deslanoside Injection, 0.5 mg/time, twice daily. The patients in the treatment group were iv administered with Human Immunoglobulin (pH 4) for iv injection, 400 mg/d. The patients in two groups were treated for 4 weeks. After treatment, the efficacy was evaluated, and the changes of LVEF, EPFV, E/A, APFV, LVESV, LV, LVEDV, CTR, and IgG antibody in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 69.00% and 85.00%, respectively, and there was difference between two groups (P < 0.05). After treatment, LVEF, E/A, and EPFV in two group were significantly increased, and APFV, LVESV, LVEDV, LV, CTR, and IgG antibody were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Human immunoglobulin combined with Deslanoside Injection has good clinical efficacy in treatment of elder dilated cardiomyopathy, and can significantly improve cardiac function, also can decrease the level of IgG antibody, which has a certain clinical application value.