柯萨奇病毒和腺病毒受体在VMC和DCM猝死者心肌组织中的表达

The Expression of Coxsackie B Virus Adenovirus Receptor(CAR) in Viral Myocarditis and Dilated Cardiomyopathy Patients

目的探讨病毒性心肌炎(VMC)和扩张性心肌病(DCM)的发病机制及相互关系。方法应用改良免疫组化技术检测病毒性心肌炎(28例)、扩张性心肌病(31例)和对照组19例。结果CAR阳性表达为棕色,主要表达于心肌细胞膜。在VMC心肌中均检测到较高水平的CAR表达(免疫组化面积积分为4.3975±0.0365);DCM组26例心肌组织中有较高水平的CAR表达(4.2064±0.0526),有5例几乎无表达(0.0723±0.0014),对照组心肌中几乎未检测到CAR的表达(0.0731±0.0362),VMC组及DCM组与对照组比较差异有显著性(P<0.05)。结论VMC和DCM心肌组织中CAR表达明显高于对照组,提示VMC和DCM的发病都有病毒感染的参与,两者可能来自同一个病因。

Objective To explore etiology and pathogenesis of viral myocarditis （VMC） and dilated cardiomyopathy （DCM）. Methods The expression of Coxsackie B virus and adenovirus receptors （CAR） were detected with modified immunohistochemical （IHC） technique in myocardium of left ventricle, right cle, interventricular septum, and septal papillary muscle from 28 patients with viral myocarditis, 31 patients with dilated cardiomyopathy and 17 control patients （including normal, hypertension heart disease, myocardial infarction and coronary atherosclerotic heart disease）. Results The brown staining on the cell mem brane of myocardium represents positive result. 100% （28 of 28） of VMC patients （IHC surface integral： 4.397 5±0.036 5） and 84% （26 of 31） of DCM patients （4.206 4±0.052 6） had prevalent CAR expression compared to 0% （0 of 19） control patients （0.073 1±0.0362）. There were statistically significant differences between VMC/DCM and control patients （P〈0.05）. Conclusion The prevalence of CAR expression was significantly higher in VMC and DCM patients （100% and 84% VS 0% in control）. In contrast, there was no difference found between VMC and DCM patients. These results suggest that both VMQ and DCM involve viral etiology and could share a similar pathogenesis.