【摘要】 目的探讨静脉注射免疫球蛋白(IVIG)对病毒性心肌炎(VMC)患儿心肌保护作用及其临床疗效。方法选择VMC患儿72例,随机分为A,B两组,并选健康查体儿童25例为对照组。A,B两组分别给予IVIG和传统综合治疗,治疗前后测定外周血T淋巴细胞亚群及心肌酶(CK,CK-MB,HBDH)、肌钙蛋白(CTnI)变化,同时观察左心室收缩功能(CO,CI,EF,FS)改变。结果A组患儿CD4+,CD8+和CK-MB,CTnI及CO,CI,EF在治疗前后比较均有显著改善(P<0.01);B组患儿治疗前后CK-MB,CTnI及CO,CI,EF也有改善(P<0.05),而CD3+,CD4+,CD8+,CD4+/CD8+则无统计学意义(P>0.05);治疗后A组较B组CD4+和CD8+有统计学意义(P<0.05),而CK-MB,CTnI,CO,CI,EF改善更明显(P<0.01)。结论IVIG能调节VMC患儿机体细胞免疫功能,改善心脏血流动力学,促进心肌细胞的恢复,而保护心肌。更多还原

【Abstract】 Objective To explore the myocardial protection and clinical efficacy of intravenous immunoglobulin（IVIG） to viral myocarditis（VMC）children.Methods Seventy two children with viral myocarditis（VMC） were randomly divided into two groups: A and B.Each group has 36 children,another 25 health children were enrolled in study as contrast.Children of group A and B were respectively received IVIG and traditional combined therapy,T-lymphocytes subsets（CD₃⁺,CD₄⁺,CD₈⁺,CD₄⁺/CD₈⁺）of the peripheral blood,Myocardium enzyme（CK,CK-MB,HBDH）and Cardiac Troponin（CTnI） were determined in prior treatment and post-treatment,the variations of the left ventricle contractile function（CO,CI,EF,FS） was also observed simultaneously.Results There is significant amelioration of CD₄⁺,CD₈⁺ and CK-MB,CTnI as well as CO,CI,EF in group A between prior treatment and post-treatment（P<0.01）.There is also amelioration of CK-MB,CTnI and CO,CI,EF in group B（P<0.05）.While the CD₃⁺,CD₄⁺,CD₈⁺,CD₄⁺/CD₈⁺ has no significance in statistics（P>0.05）.The difference of CD₄⁺ and CD₈⁺ of post-treatment between group A and B has statistical significance（P<0.05）.Meanwhile,the CK-MB,CTnI,CO,CI,EF in group A was improved obviously much more than group B（P<0.01）.Conclusion IVIG can regulate the cellular immune function,improve the Cardiac hemodynamics and promote the restoration of the myocardial cells to protect the myocardium of the VMC children.更多还原