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目的研究病毒性心肌炎患儿IL-10和IL-8的表达;分析患儿IL-10、IL-18的表达与病情程度的相关性。方法按照1999年9月修订的小儿病毒性心肌炎诊断标准选取天津市儿童医院心内科病毒性心肌炎患儿72例;病人组分为无心衰组、心衰组和休克组,对照组选自防病外科患儿25例。采用双抗体夹心ELISA方法检测对照组、病人组患儿的IL-10和IL-18含量。结果病人组血清IL-10、IL-18的表达高于对照组(P<0.01),其中无心衰组、心衰组、休克组血清IL-10、IL-18的表达均高于对照组(P<0.01);血清IL-10、IL-18的表达与病情分组(对照组、无心衰组、心衰组和休克组)呈等级正相关(P<0.05);直线回归得出IL-18与病情程度的方程:lg(IL-18)=2.435+0.237×PC(病情程度)。结论①病毒性心肌炎患儿血清IL-10、IL-18明显升高,尤以心源性休克合并心力衰竭时升高明显,与病情程度密切相关,可以作为病毒性心肌炎患儿判别病情程度的参考指标,可以作为急性期判别其状况和预后的参数之一。②白介素家族10、18可以作为评价病毒性心肌炎免疫状况的指标,指导临床合理应用免疫抑制剂、免疫调节剂和抗病毒药物。
Objective To investigate the expression of IL-10 and IL-8 in children with viral myocarditis and to analyze the correlation between the expression of IL-10 and IL-18 in children with the severity of illness. Methods According to the diagnostic criteria of pediatric viral myocarditis revised in September 1999, 72 children with viral myocarditis in Tianjin Children’s Hospital were enrolled. The patients were divided into two groups: heart failure group, heart failure group and shock group. 25 cases of sick children. Double antibody sandwich ELISA was used to detect the levels of IL-10 and IL-18 in control group and patient group. Results The serum levels of IL-10 and IL-18 in patients were higher than those in control group (P <0.01). The levels of IL-10 and IL-18 in heart failure group, heart failure group and shock group were higher than those in control group (P <0.01). The levels of IL-10 and IL-18 in serum were positively correlated with disease group (control group, no heart failure group, heart failure group and shock group) -18 and the severity of the equation: lg (IL-18) = 2.435 + 0.237 × PC (severity). Conclusion ① serum IL-10 and IL-18 in children with viral myocarditis increased significantly, especially in patients with cardiogenic shock and heart failure increased significantly, closely related with the severity of the disease, can be used as children with viral myocarditis to determine the severity of the disease Reference indicators, can be used as one of the parameters to determine the status and prognosis of acute phase. ② Interleukin 10,18 can be used as an index to evaluate the immune status of viral myocarditis, and guide the rational use of immunosuppressants, immunomodulators and antiviral drugs in clinic.