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目的:初步探讨急性病毒性心肌炎患者辅助性T细胞(Thelp,Th)17细胞在其发病中的作用。方法:选择2008年3-11月在我院住院的急性病毒性心肌炎(AVMC)患者13例、扩张型心肌病(DCM)患者18例,采用ELISA法分别检测其外周血Th17细胞分泌的细胞因子白细胞介素(IL)-17和抗心肌抗体(AHA)的表达、三色流式细胞术检测CD4+T细胞中Th17/Th1/Th2细胞亚群的比例、实时定量PCR法检测B细胞表面IL-17R基因水平,同时选取16例健康人为对照(对照组)结果:AVMC和DCM患者Th1细胞亚群[(10.7±1.4)%、(5.2±1.1)%]、B细胞总数[(21.8±2.1)%、(16.4±1.6)%]及其IL-17RmRNA表达水平(132.4±12、37.5±6.4)较对照组[(3.1±0.8)%,(10.9±1.5)%,16.6±5.7]均有升高,但以AVMC患者更为明显(均P<0.01),且AVMC患者外周血IL-17和Th17细胞亚群也有显著增高[89.2±11.6,(5.5±2.1)%],Th2细胞无明显变化,AHA阳性率为12/13(92.3%);而DCM患者Th2细胞[(6.0±3.2)%]增多超过Th1细胞,IL-17含量和Th17细胞比例与对照组相比差异均无统计学意义,AHA阳性率为10/18(55.6%),表达水平也低于AVMC组。对照组AHA检测均为阴性。结论:Th17细胞可能在AVMC急性炎症和B细胞产生AHA方面均有重要作用。
Objective: To investigate the role of the Aβ (Th17) cells in the pathogenesis of acute viral myocarditis. Methods: Thirteen patients with acute viral myocarditis (AVMC) hospitalized in our hospital from March to November in 2008 and 18 patients with dilated cardiomyopathy (DCM) were enrolled in this study. The levels of cytokines secreted by Th17 cells in peripheral blood were measured by ELISA. (IL-17) and anti-myocardial antibodies (AHA). The proportion of Th17 / Th1 / Th2 subsets in CD4 + T cells was detected by three-color flow cytometry. The level of IL- (17.7 ± 1.4)%, (5.2 ± 1.1)%], the total number of B cells [(21.8 ± 2.1) cells in AVMC and DCM patients, ), (16.4 ± 1.6)% and IL-17R mRNA expression level (132.4 ± 12,37.5 ± 6.4) were significantly higher than those in the control group [(3.1 ± 0.8)%, (10.9 ± 1.5)%, 16.6 ± 5.7] (P <0.01). The levels of IL-17 and Th17 in peripheral blood of AVMC patients were significantly higher than that of AVMC patients [89.2 ± 11.6 (5.5 ± 2.1)%], but no significant changes in Th2 cells The positive rate of AHA was 12/13 (92.3%). However, there was no statistical difference in the proportion of Th2 cells between Th1 cells and Th1 cells in DCM patients (6.0 ± 3.2% Significance, AHA positive rate was 10/18 (55.6%), expression The level is also lower than the AVMC group. AHA test in the control group were negative. Conclusion: Th17 cells may play an important role in the acute inflammation of AVMC and the production of AHA by B cells.