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目的 了解病毒性心肌炎 (VM)患儿的免疫功能改变和皮质激素对免疫的影响。方法 对 4 0例VM患儿用皮质激素治疗前后分别测定 CD3、CD4 、CD8、CD4 / CD8;对 2 2例治疗前和 13例发病 10天内、9例发病10天后 VM患儿用皮质激素治疗后 ,分别测定 T淋巴细胞凋亡率 (TL AR) ;对 92例治疗前、6 2例常规治疗后、30例皮质激素治疗后 VM患儿分别测定抗心磷脂抗体 (ACPA)。结果 VM患儿 CD3、CD4 无变化 ,CD8升高 ,CD4 /CD8下降 ,皮质激素对 T淋巴细胞亚群无影响。VM患儿 TL AR增加 ,发病 10天内用皮质激素可增加 TL AR,10天后应用激素对 TL AR无影响。 VM患儿 ACPA阳性率增加 ,皮质激素可降低 ACPA阳性率。结论 VM患儿CD8升高、CD4 / CD8降低 ,皮质激素治疗对其无影响。 VM患儿 TL AR增加 ,发病 10内用皮质激素可增加TL AR,10天后对其无影响。 VM患儿 ACPA升高 ,皮质激素可降低 ACPA阳性率。
Objective To investigate the effects of corticosteroid on immune function in children with viral myocarditis (VM). Methods CD3, CD4, CD8 and CD4 / CD8 were measured before and after treatment with corticosteroids in 40 children with VM. Nineteen children with VM were treated with corticosteroid 10 days before and after the onset of disease T lymphocyte apoptosis rate (TL AR) was measured respectively. Before anticancer therapy, 62 children with VM were measured anticardiolipin antibody (ACPA) after 62 routine treatment. Results There was no change of CD3 and CD4 in children with VM, the increase of CD8, the decrease of CD4 / CD8, and no effect of corticosteroids on T lymphocyte subsets. TL in children with VM increased, the incidence of 10 days with corticosteroids can increase TL AR, 10 days after the application of hormones TL TL no effect. The positive rate of ACPA in children with AC increased, corticosteroids can reduce the positive rate of ACPA. Conclusions CD8 in children with VM is increased and CD4 / CD8 is decreased. Corticosteroid therapy has no effect on it. TL in children with increased VM, the incidence of 10 within the corticosteroids can increase TL AR, 10 days after its no effect. ACPA increased in children with ACPA, corticosteroids can reduce the positive rate of ACPA.