血清IL-35在病毒感染致心肌炎患者中治疗前后的变化研究

Changes of serum IL-35 in patients with myocarditis induced by virus infection before and after treatment

目的探讨血清白细胞介素-35(IL-35)在病毒感染致心肌炎患者中治疗前后的变化。方法选取2012年2月-2016年2月医院收治的68例病毒性心肌炎患者为试验组。另选取同期健康体检的健康人群70例为对照组。采集研究对象静脉血检测病毒,检测肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTn I)、IL-17、IL-35和干扰素-γ(IFN-γ)。结果 68例病毒性心肌炎患者中共检出68株病毒,其中RNA病毒41株占60.29%,DNA病毒27株占39.71%。检出前三位的病毒是柯萨奇病毒B、柯萨奇病毒A和疱疹病毒I型。68例病毒性心肌炎治愈15例,显效35例,有效16例,无效2例,总有效率为97.06%(66/68)。试验组血清IL-17、CK-MB、cTn I和IFN-γ水平分别为(512.75±38.29)pg/ml、(33.55±6.31)U/ml、(0.50±0.22)μg/ml和(1368.62±715.28)ng/L均高于对照组(P<0.05),血清IL-35为(192.52±29.35)ng/ml低于对照组(P<0.05)。试验组患者治疗后血清IL-17、CK-MB、cTn I和IFN-γ水平均降低,血清IL-35水平升高(P均<0.05)。不同预后患者治疗前IL-35水平差异有统计学意义(P=0.010)。结论 IL-35在病毒性心肌炎的发生、发展过程中具有重要作用,其基线水平的高低可作为病毒性心肌炎预后判断的重要指标之一。

OBJECTIVE To investigate the changes of serum interleukin-35（IL-35）in patients with myocarditis caused by viral infection before and after treatment.METHODS From Feb.2012 to Feb.2016,68 patients with viral myocarditis were treated as observation group.In addition,70 healthy people were selected as control group.Venous blood of patients were collected for detection of virus,and creatine kinase isoenzyme（CK-MB）,troponin I（cTn I）,IL-17,IL-35 and interferon-γ（IFN-γ）were measured.RESULTS Sixty-eight viruses were detected in68 patients with viral myocarditis.Among them,41 were RNA viruses,accounting for 60.29%,and 27 were DNA viruses,accounting for 39.71%.The top three viruses were Coxsackie virus B,Coxsackie virus A and herpes virus type I.Among 68 cases of viral myocarditis,15 cases were cured,35 cases were markedly effective,16 cases were effective,and 2 cases were non-effective,and the total effective rate was 97.06%（66/68）.The levels of serum IL-17,CK-MB,cTn I and IFN-γin the observation group were（512.75±38.29）pg/ml,（33.55±6.31）U/ml,（0.50±0.22）μg/ml and（1368.62±715.28）ng/L,which were significantly higher than those in the control group（P〈0.05）,and the level of serum IL-35 was（192.52±29.35）ng/ml,which was significantly lower than that of the control group（P〈0.05）.The levels of serum IL-17,CK-MB,cTn I and IFN-γwere significantly decreased（P〈0.05）,and the serum IL-35 level was significantly increased（P〈0.05）in the observation group after treatment.There were significant differences in IL-35 levels between patients with different prognostic viral myocarditis before treatment（P=0.010）.CONCLUSIONIL-35 plays an important role in the development and progression of viral myocarditis,and its baseline level can be used as one of the important indexes to judge the prognosis of viral myocarditis.