病毒性心肌炎患儿免疫状况的研究

目的：探讨病毒性心肌炎 (VMC)患儿在细胞免疫、体液免疫和自身免疫方面的改变，从而指导免疫治疗。方法：用流式细胞技术分别测定 30例急性期、2 2例迁延期VMC患儿及30例对照的血清CD2 3，CD3/HLA DR，用比浊法测IgG，IgA和IgM。 结果：VMC患儿急性期、迁延期的CD2 3,IgG ,IgA ,IgM及CD3+ /HLA -DR+，CD3-/HLA -DR+ 细胞比例均高于正常对照组 (P均 <0 .0 1)。VMC患儿CD2 3和IgG ,IgA ,IgM呈正相关 (r分别=0.30，0.17，0.40，P<0.0 5)，而急性期、迁延期VMC患儿的CD3+ /HLA DR-细胞表达率与正常对照组相比均无明显差异 (P均 >0 .0 5 )。迁延期患儿的各项指标和急性期相比无明显差异(P均>0.05)。结论：病毒性心肌炎患儿急性期、迁延期的细胞免疫、体液免疫均处于增强状态，提示细胞免疫、体液免疫可能参与了VMC患儿的心肌损伤。

Immunological Status of Children with Viral Myocarditis

OBJECTIVE: To study the exact changes of cellular immunity, humoral immunity, and autoimmunity in children with viral myocarditis in order to guide the immune therapy. METHODS: Using the flow cytometer the levels of CD23 and CD3/HLA-DR were detected in 52 children with viral myocarditis and 30 healthy children, and the levels of IgG, IgA and IgM were measured by the method of turbidimetry. RESULTS: In the acute and procrastinating stages of viral myocarditis, the levels of CD23 and IgG, IgA, IgM, CD3+/HLA-DR+ and CD3-/HLA-DR+ were significantly elevated compared with the control group (P<0.01). The elevation of CD23 was positively correlated with the elevation of IgG, IgA and IgM. There was no obvious difference in any of the immunogical indices measured between the acute and procrastinating stages of viral myocarditis. CONCLUSIONS: Cellular immunity and humoral immunity in the acute and procrastinating stages of viral myocarditis were in an enhancing state. It indicates that the cellular immunity and humoral immunity might be involved in the immune damage of children with viral myocarditis.