肠病毒感染及抗ADP/ATP载体抗体在病毒性心脏病发病中的意义

Significance of enterovirus infection and antibody against ADP/ATP carrier in the etiology of viral heart disease

目的 :探讨肠病毒感染与抗二磷酸腺苷 /三磷酸腺苷 (ADP/ ATP)载体抗体在病毒性心脏病发病中的意义。方法 :应用逆转录聚合酶链式反应 (RT- PCR)和免疫转印法对临床诊断为病毒性心肌炎 (VMC)和扩张型心肌病 (DCM)患者进行肠病毒核糖核酸 (RNA)及抗 ADP/ ATP载体抗体的检测。结果 :RT- PCR方法检测肠病毒 RNA,VMC组 (n =74) 4 2例 (56.8% )阳性 ,DCM组 (n=2 6) 1 1例 (42 .3% )阳性。与健康组 (n =30 )比较具有显著性差异 (分别 P <0 .0 1 ,P <0 .0 5) ;肠病毒感染与 DCM患者心脏功能降低有明显相关性。免疫转印法检测 VMC(n =34)和 DCM(n =2 6)患者血清抗 ADP/ ATP载体抗体 ,VMC组 2 3例 (67.6% )阳性 ,DCM组 1 2例 (46.2 % )阳性 ,而健康组均为阴性 ;抗 ADP/ ATP载体抗体和肠病毒 RNA的检出相关 (r=0 .442 )。结论 :肠病毒RNA和抗 ADP/ ATP载体抗体在病毒性心脏病患者中检出具有相关性 ,对临床上出现前驱感染和心脏症状的患者 ,及时进行肠病毒 RNA、CVB- Ig M、抗 ADP/ ATP载体抗体的检测 ,有助于 VMC和 DCM的早期诊断。

Objective:To evaluate the roles of enterovirus (EV) infection and autoantibody against ADP/ATP carrier in the pathogenesis of viral heart disease (VHD). Method:The reverse transcription polymerase chain reaction (RT PCR) amplification assay and western blot assay were developed to detect EVs ribonucleic acid (RNA) and autoantibody against ADP/ATP carrier in sera from patients suspected of viral myocarditis(VMC) and DCM. Result:42 of 74( 56.8 %) patients with VMC and 11 of 26( 42.3 %) patients with ditaled cardiomyo pathy(DCM) suffered from EVs RNA infection,both were much higher than the health group (n=30). The EVs RNA infection had marked correlation to the heart function in patients with VHD. The autoantibody against ADP/ATP carrier could be found in 23 of 34( 67.6 %) patients with VMC and 12 of 26( 46.2 %) patients with DCM, while it was negative in the health group. The autoantibody against ADP/ATP carrier and the EVs RNA infection had marked correlation in patients with VHD (r= 0.442 ). Conclusion:The EVs RNA and autoantibody against ADP/ATP carrier could be detected in patients with VHD. To the patients who had precursory infection and cardiac symptoms, the detection of EVs RNA,CVB IgM, and autoantibody against ADP/ATP carrier could contribute to th early stage diagnosis of the viral heart diseases.