小儿病毒性心肌炎外周血淋巴细胞凋亡及其意义

目的　探讨心肌炎患儿淋巴细胞凋亡的改变、细胞免疫状况及干预治疗的效果。方法　选择临床诊断心肌炎患儿 2 0例 ,采用光镜技术及原位末端标记法 (TUNEL)检测患儿外周血淋巴细胞凋亡情况 ,同时检测患儿治疗前后心肌酶谱、T淋巴细胞亚群的动态变化。另外以 13例正常健康查体儿童作为对照组。结果　心肌炎患儿外周血淋巴细胞凋亡检出率为 10 0 % ,凋亡率为 5 .5 % ,明显高于正常对照组 (P <0 .0 5 ) ,急性期T淋巴细胞亚群中的CD4,CD8下降 ,与治疗后及对照组比较差异有显著性 (P <0 .0 5 )。心肌酶谱在治疗前后有明显变化 (P <0 .0 1)。结论　病毒性心肌炎的发病过程与细胞凋亡过度导致T淋巴细胞免疫功下降有关 ,其相关性呈动态变化 ,可作为病情变化的观察指标

The Study of Apoptosis in Lymphocyte and Its Meaing in Children with Myocarditis

Objective To determin the change of apoptosis of peripheral blood lymphocytes,the cell immunologic status and the effect of interfereotherapy in children with myocarditis.Methods 20 cases with vival myocarditis diagnosised in clinical were selected.Apoptosis of peripheral blood lymphocytes together with Myocardial enzyme and T-lymphocyte subgroup were studied by microscpy and TUNEL methods.13 normal children were observed as contrast group.Results The total apoptosis rates which can be determined effectively were 100%.There were very siynificant decline in Apoptosis of peripheral blood lymphocytes(P<0.05) in comparion with normal contrast group.T-lymphocyte subgroup CD 4 and CD 8 distinctly descended with siynificant decline in myocardial enzyme(P<0.01) before and after treatment.Conclusions The pathogenesis of myocarditis in children has correlated with whole immune function decline which result from lymphocytic over-apoptosis,and the correlation changes respondently.So apptosis of T-lympholyte can be used as asupplementary index to reflect the severtity of myocarditis,and earlier interfereotherapy is advocated.