| Background:Children with congenital heart disease(CHD) are vulnerable for infections. The alteration of blood kinetic and mechanic factors are traditionally thought to be the cause,but literatures in the last years show that CHD may be a part of Digeorge syndrome(DGS) and that the susceptibility to infection in children with CHD may be related to partial primary immunodeficiency.Objective:To explore whether there is immunodeficiency in children with CHD in terms of measurement of thymus shadow on X-ray film during neonate stage,the immunologic and parathroid functions in the early childhood were observed and to clarify the relationship between CHD and DGS by reviewing literatures.Methods:1 Partial immunologic laboratory data from peripheral blood were observed in 28 children with simple CHD and 20 age matched healthy children servered as a control.1.1 Classification of lymphocytic subsets measured by monocloneantibodies and flow cytometer.1.2 The mRNA expression of IL-4 and IFN-γin peripheral blood monoeuclear cell(PBMC) stimulated with phytohaemagglutinin(PHA)and the levels of IL-4 and IFN-γin supernatant were measured by reverse transcription and polymerase chain reaction(RT-PCR) and enzyme-linked immuno-sorbent assay(ELISA) respectively. 1.3 The proliferative response of PBMC stimulated with PHA and lipopolysaccharide(LPS) were measured by intake of 3H-thymidine(3H-TdR) technique.1.4 Serum IgG,IgA,IgM and C3 levels were estimated by immune scatter turbidimetry.2 The size of thymus shadow of chest X ray films in 106 neonates including 74 simple and 34 complex CHD were measured retrospectively.50 neonates with pneumonia enrolled in the control.3 The serum parathyrin(PTH),Ca2+ and Mg2 in 18 children with simple CHD and 17 age matched healthy children were estimated by immunoradiometric assay(IRMA),ion selective electrode(ISE) and methyl thyme camphor blue(MTB) respectively.Results:1 The amount of total T and CD8+T lymphocytes was higher and the ratio of CD4/CD8, the amount of NK cells and total B cells were lower in children with CHD as compared with control,but no significant statistic difference was found. The number of CD4+T lymphocytes in both CHD and control was the same. The peripheral blood lymphocytic subsets in children with CHD and control were changed along with age increasing,but no significant statistic difference.2 Comparing with normal control, proliferative response of PBMC stimulated with PHA and LPS in children with CHD was normal.3 The IL-4mRNA expression in PBMC and the levels of IL-4 in supernatants of PBMC were lower gently,IFN-γmRNA expression in PBMC and the levels of IFN-γ in supernatants of PBMC were higher gently in children with CHD as compared with controls,but there were no significant statistic differences.4 The serum levels of IgG and IgA in CHD children were higher,and IgM and complement C3 were lower than those in controls,.but no significant differences were found. The levels of IgG rised gently as their age increased in both groups,but no significant statistic difference were found.5 The thymus shadow of X-ray film was found in all neonates both CHD and controls with variance in shape and size. The sizes of thumus shadow for simple and complex CHD were no different.6 The serum levels of PTH in children with CHD were significantly lower as compared with controls. The level of PTH below 10ng/L was found in 8 cases in CHD group,but none of the controls.The serum concentration of Ca2+ and Mg2+ was mildly decreased in CHD group in comparation with controls,but there were no statistic significance.Conclusion:1 Immunodeficiency does not exist in children with CHD enrolled in this study.2 Simple CHD probably is not a part of DGS. Even if it belongs to DGS,it would not be complete DGS(cDGS), may be partial DGS(pDGS),without significant immunodeficiency.3 It is unlikely that children with CHD tending to pulmonary infection is caused by primary immunode...
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