摘要
目的 探讨病毒性心肌炎患儿细胞的免疫状况 ,为估计病情和预后提供客观依据。方法 对 48例急性期和 2 9例迁延期及慢性期病毒性心肌炎患儿的细胞免疫状况进行了动态观察 ,测定不同时期病毒性心肌炎患儿的外周血T淋巴细胞亚群、白细胞介素 2膜受体 (mIL 2R)的表达及血浆可溶性白细胞介素 2受体 (sIL 2R)、肿瘤坏死因子α(TNF α)的水平和白细胞介素 2 (IL 2 )产生水平的动态变化。结果 在病毒性心肌炎急性期 ,患儿外周血T淋巴细胞亚群中的CD+3、CD+4 、CD+8细胞下降 ,CD+4 /CD+8比值上升 ,单个核细胞的mIL 2R表达下降 ,血清sIL 2R浓度、TNF α浓度上升 ,活化T淋巴细胞产生IL 2水平下降。随着病情的逐渐恢复 ,上述指标逐渐趋于正常。而迁延期或慢性期患儿的CD+3、CD+4 细胞正常 ,CD+8细胞下降 ,CD+4 /CD+8比值上升 ,与正常相比差异有显著性 ,mIL 2R表达下降 ,sIL 2R、TNF α浓度及IL 2水平升高。结论 细胞免疫在心肌炎的致病中起一定作用 ,其相关指标呈动态变化 ,可作为病情变化及预后的一个观察指标及依据。
Objective Reconfirm the cell immunologic status of viral myocarditis during the pathogenesis in order to evaluate the prognosis of the disease objectively. Methods In the present study, the peripheral blood T lymphocyte subsets, mIL 2R expression, serum sIL 2R, TNF α and IL 2 levels were detected in children with viral myocarditis which were included 48 cases at the acute stage, and 29 cases at the procrastinate and chronic stages. Results The results showed that in the acute stage of viral myocarditis, the peripheral blood T lymphocyte subsets (CD + 3,CD + 4, CD + 8 cells ) decreased significantly ( P <0.01), while CD + 4/CD + 8 was higher in patient group than in control group. In addition, the expression of mIL 2R reduced ( P <0.01), the serum IL 2, sIL 2R and TNF α levels decreased. However, at the procrastinate and chronic stages, CD + 3 and CD + 4 cells did not change, but CD + 8 cells decreased remarkably ( P <0.01). Conclusion The determination of peripheral blood T lymphocyte subsets, TNF α, IL 2 and IL 2R was important in studying the pathogenesis of viral myocarditis and estimating the patients' prognosis.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2000年第2期76-79,共4页
Chinese Journal of Pediatrics
关键词
心肌炎
T细胞亚群
白细胞介素
儿童
Myocarditis
T- lymphocyte subsets
Interleukin 2
Immunity, cell
