静脉丙种球蛋白对病毒性心肌炎作用的研究

Protective and Therapeutic Effects of Intravenous immunoglobulin on Viral Myocarditis

为探讨国产人静脉血丙种球蛋白（ＩＶＩＧ）对病毒性心肌炎的保护及治疗作用，取ＢＡＬＢ／ｃ小鼠随机分为ＩＶＩＧ保护组与治疗组。保护组接种柯萨奇Ｂ３病毒（ＣＶＢ３）后，立即使用剂量分别为２００ｍｇ·ｋｇ－１·ｄ－１、５００ｍｇ·ｋｇ－１·ｄ－１、１ｇ·ｋｇ－１·ｄ－１的ＩＶＩＧ７天。治疗组则将接种ＣＶＢ３后存活到１周的小鼠，使用上述三个剂量的ＩＶＩＧ治疗７天。１４天后处死动物。分别评价生存率、体重（ＢＷ）、心脏重量（ＨＷ）、心脏重／体重及心肌炎症的病理组织学改变。结果：保护组中５００ｍｇ及１ｇ组动物存活率１００％，未发生心肌炎症；２００ｍｇ组生存率为９５％，个别动物有轻微心肌炎症发生，与对照组比较差异显著（Ｐ＜０．０１）。治疗组心肌炎症均有减轻，发病症状减轻或消失，生存率提高，ＢＷ增加，ＨＷ及病灶面积较小，但２００ｍｇ组与对照组比较差异无显著性；５００ｍｇ及１ｇ组与对照组比较差异有显著性（Ｐ＜０．０５），但两者间差异无统计学意义。

This study was conducted to determine whether the administration of domestically manufactured intravenous immunoglobulin (IVIG) could prevent or alleviate myocarditis in mice. Male BALB/c mice were randomized into two groups for protection group (P) and therapy group (T), and each of the two groups was subdivided into 4 groups (1,2,3 and c). A 7 day protocol with daily IVIG dosage of 200mg/kg, 500 mg/kg and 1 g/kg for groups, P 1,T 1,P 2, T 2 and P 3, T 3 respectively was designed. In the experiment, the mice were inoculated with Coxsacki virus B3. The prevention groups (P 1,P 2,P 3) received IVIG in the week immediately after the inoculation; the therapy groups (T 1,T 2,T 3) received IVIG in the second week after the inoculation. All the animals were observed for 14 days. The results showed that all mice in groups P 2 and P 3 survived and the pathological studies revealed no myocarditic change. By the end of observation, however, 7 mice in the control group (P c) died with severe myocarditic changes while one mouse in group P 1 died with only slight inflammatory lesions in the heart. The survival rates of groups P 1,P 2 and P 3(95%, 100%and 100%) differed significantly from the control (65%) statistically ( P<0.05) . Similarly, the results of computed image analysis demonstrated that a significant difference existed between the cardiac lesions of groups P 1 and P c in severity ( P<0.05) . The survival rates were 80.0%, 93.3%, 93.3% and 53.3% for groups T 1,T 2,T 3 and T c respectively ( P<0.05 for T 2,T 3 v.s. control),yet the hearts and heart/body weight ratios of T 2 and T 3 were significantly smaller than those of control, pathological study was supportive which showed slight (T 2 and T 3) or mild (T 1) lesions of the heart in comparision with the control.These results demonstrate that Chinese made IVIG has definite protective and therapeutic effects on the mice infected with CVB3.