病毒性心肌炎外周血淋巴细胞凋亡与坏死的临床与实验研究

摘要

To investigate the relationship and clinical significance between apoptosis and necrosis of peripheral blood lymphocytes in children and murine models with viral myocarditis．Annexin／PI was used to measure quantitatively the percentage of apoptosis and necrosis in peripheral blood lymphocytes by using flow cytometry．The results showed that the percentage of apoptosis and necrosis in peripheral blood lymphocytes was much higher in children with viral myocarditis than that in normal control children（P＜0．001），and there was a positive correlation between the percentage of apoptosis and necrosis（r＝0.81，P＜0．01）．The similar results were observed in murine myocarditis.Both the percentage of apoptosis and necrosis correlated positively with myocardial histopathological score（P＜0．001）．The increasing of lymphocytes apoptosis and necrosis in peripheral blood resulted in the decrease of cell immunologic function．The percentage of apoptosis and necrosis in peripheral blood lymphocytes can be used to estimate the severity of myocardial histopathology．%为探讨病毒性心肌炎患儿外周血淋巴细胞凋亡与坏死的关系及其临床意义，采用Annexin V／PI双参数技术在流式细胞仪上定量检测了20例病毒性心肌炎患儿和40只CVB3小鼠外周血淋巴细胞凋亡及坏死百分率。结果显示，病毒性心肌炎患儿外周血淋巴细胞凋亡率和坏死率均显著高于正常儿童（r＝0．81，P均＜0．001），凋亡率与坏死率呈正相关（P＜0.01）；动物实验取得相似结果，且心肌炎小鼠外周血淋巴细胞凋亡率及坏死率均与心肌病理积分呈显著正相关（P均＜0.01）。认为病毒性心肌炎时外周血淋巴细胞凋亡和坏死明显增多为细胞免疫功能下降的原因；外周血淋巴细胞凋亡率和坏死率均可间接反映心肌病理损害程度。