The Clinical Significance Of Dynamic Changes Of Peripheral Sera SD40L And HsCRP Concentration In Children With Viral Myocarditis

Objective:The pathogenesis of viral myocarditis remains to be fully expounded. There is a popular belief that the direct damage of the virus and the myocardial injury resulting from immune responses mediated by viral infections are the main mechanisms leading to the pathogenesis of viral myocarditis, among which immune responses mediated by T cell play an important part. Among the costimulatory signaling pathways in the T cell activation, CD40-CD40L is an important costimulatory molecule. sCD40L, the soluble form of CD40L, can be combined with CD40. High sensitivity C-reactive protein (hsCRP) is a kind of CRP with low concentration detected using ultra-sensitive method, which has higher sensitivity than CRP. This study is designed to detect content changes of sera sCD40L and hsCRP in children with viral myocarditis before and after treatment, and explore the clinical significance of sCD40L and hsCRP in viral myocarditis.Materials and Methods:Select30cases of clinically diagnosed children with viral myocarditis as the case group,30cases of healthy children as the control group. Detect peripheral sera contents of sCD40L and hsCRP in the two groups. Two weeks after clinical treatment, the peripheral sera contents of sCD40L and hsCRP in case group are detected once more, then the content changes of which are analyzed with the results of cardiac enzymes, electrocardiogram and heart anatomy. Results:1. Prior to treatment, the serum sCD40L content (8.10±2.08)ng/ml in case group is significantly higher than that (3.85±1.28)ng/ml in control group (P<0.05), and there is no obvious fall after treatment (P>0.05).2. Before treatment, the serum hsCRP content(12.42±3.40)mg/L in case group is significantly higher than that(1.80±1.07) mg/L in control group ((P<0.05); and there is obvious decrease after treatment ((P<0.05).3. The serum sCD40L contents increase in some children, and the incidence rate of cardiac enzymes increase, electrocardiogram is abnormal, heart chamber expands and heart chamber motion weakens is obviously higher than those whose sCD40L are normal ((P<0.05).4. The serum hsCRP contents increase in some children, and the incidence rate of cardiac enzymes increase, electrocardiogram is abnormal, heart chamber expands and heart chamber motion weakens is obviously higher than those whose hsCRP are normal (P<0.05).Conclusion:1. The serum sCD40L contents increase in some children, and it is closely related to the increase of cardiac enzymes, the abnormalty of electrocardiogram, the expansion of heart chamber and weakening of heart chamber motion, which indicates that sCD40L can reflect the severity of viral myocarditis.2. The serum hsCRP contents increase in some children, decrease after treatment, and it is closely related to the increase of cardiac enzymes, the abnormalty of electrocardiogram, the expansion of heart chamber and weakening of heart chamber motion, which indicates that hsCRP changes in accordance with the condition and course changes of viral myocarditis in the children, and hsCRP can be used as an auxiliary index for the clinical diagnosis.