亚急型克山病患儿的多器官肠道病毒感染

Enteroviral multi- organ infection in children with subacute Keshan disease

目的 了解亚急型克山病患儿是否存在多器官的肠道病毒感染及肠道病毒感染与亚急型克山病发病的关系。方法 应用逆转录套式聚合酶链反应对 10例亚急型克山病患儿多器官进行肠道病毒基因组RNA检测。结果 发现在患儿心、肝、脾、肺、肾、胰腺及膈肌标本中 ,病毒基因阳性者分别为 9/ 10、4/ 10、3/ 8、6 / 10、2 / 6、5 / 10和 5 / 6 ,而非感染性疾病死亡者心、肝、肺及胰腺均未检测到病毒。结论 亚急型克山病可能是由肠道病毒感染所致的以心肌病变为主的多器官感染性疾病。

Objective Increasing evidences suggest that enteroviral infection is associated with the pathogenesis of Keshan disease; the present study was conducted to see if enteroviral multi organ infection exists in children with subacute Keshan disease. Method Enteroviral genomic RNA from autopsy heart, liver, spleen, lung, kidney, pancreas and diaphragm tissues of patients with subacute Keshan disease and non infection diseases was respectively detected by using reverse transcription nested polymerase chain reaction (RT NPCR). Results Positive PCR signals were found in 9/10 in heart, 4/10 in livers, 3/8 in spleens, 6/10 in lungs, 2/6 in kidneys, 5/10 in pancreas and 5/6 in diaphragms of the 10 patients with Keshan disease, whereas all samples of heart, liver, lung and pancreas from 10 patients with non infectious diseases were negative. Conclusion These results support the hypothesis that subacute Keshan disease may be caused by enteroviral infection of multi organs, predominantly involves myocardial tissues.