病毒性心肌炎患者治疗前后血清IL-35水平的变化及其意义

Change of serum IL-35 level in patients with viral myocarditis before and after treatment and its clinical significance

目的观察病毒性心肌炎患者治疗前后血清白细胞介素35(IL-35)水平的变化,探讨其在病毒性心肌炎中的临床意义。方法选取2012年1月-2015年12月在该院心内科住院的病毒性心肌炎患者54例,以及健康体检者54例作为研究对象,将其分为观察组和对照组,测定血清IL-35、心肌肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶(CK-MB)、白细胞介素17(IL-17)水平。结果 54例患者总有效率为94.4%。治疗前观察组IL-35([189.34±25.46)ng/L]与对照组([398.35±24.27)ng/L]比较,差异有统计学意义(P<0.05),观察组cTnI、CK-MB和IL-17水平([0.45±0.04)μg/L、(34.53±4.37)u/L和(546.57±24.34)pg/ml]与对照组([0.03±0.01)μg/L、(8.57±1.26)u/L和(183.34±13.26)pg/ml]比较,差异有统计学意义(P<0.05)。观察组治疗后IL-35水平([366.35±22.43)ng/L]与治疗前([189.34±25.46)ng/L]比较,差异有统计学意义(P<0.05),治疗后cTnI、CK-MB和IL-17水平([0.07±0.02)μg/L、(11.35±1.65)u/L和(276.48±17.46)pg/ml]与治疗前([0.45±0.04)μg/L、(34.53±4.37)u/L和(546.57±24.35)pg/ml]比较,差异有统计学意义(P<0.05)。治疗前后,男性和女性患者血清IL-35水平比较,差异无统计学意义(P>0.05)。病毒性心肌炎患者血清IL-35水平与cTnI、CK-MB、IL-17呈负相关(P<0.05)。结论病毒性心肌炎患者血清IL-35水平下降,经治疗后血清IL-35水平升高,IL-35可能参与病毒性心肌炎的发生、发展过程。

Objective To observe the change of serum interleukin-35 （IL-35） level in patients with viral myocarditis before and after treatment and to explore its clinical significance. Methods This study included 54 patients with viral myocarditis （observation group） and 54 healthy subjects （control group）. The levels of serum IL-35, cardiac troponin I （cTnI）, creatine kinase isoenzyme （CK-MB） and interleukin-17 （IL-17） were measured. Results The total effective rate in the observation group was 94.4% （51/54）. The IL-35 level in the observation group before treatment [（189.34 ± 25.46） ng/L] was lower than that in the control group [（398.35 ± 24.27） ng/L, P〈 0.05]. The levels of cTnI, CK-MB and IL-17 in the observation group were significantly higher than those in the control group （P〈0.05）. In the observation group, the IL-35 level after treatment was significantly higher than that before treatment （P〈0.05）; the levels of cTnI, CK-MB and IL-17 after treatment were significantly lower than those before treatment （P〈0.05）. Before and after treatment, the serum IL-35 levels in the male and female patients were not significantly different （P〉0.05）. The serum IL-35 level was negatively correlated with the serum levels of cTnI, CK-MB and IL-17 in the patients with viral myocarditis （P〈0.05）. Conclusions Serum IL-35 level decreases in patients with viral myocarditis. After treatment, serum IL-35 level increases. IL-35 may be involved in the development of viral myocarditis.