PCR测定血中柯萨奇病毒B RNA对确定病毒性心肌炎病原诊断的价值

Value of Coxsackie Virus B-RNA Assay by the PCR Technique to Identify the Viral Pathogen of Myocarditis

目的 研究PCR技术测血中柯萨奇病毒B RNA(CVB-RNA)对病毒性心肌炎病毒病原诊断的价值及其阳性率与病程的关系。方法 对75只小鼠腹腔注射CVB3病毒后，做心肌病理检查和检测血液中CVB-RNA。对145例临床诊断心肌炎患儿测定血中CVB-RNA，对比病毒性心肌炎患儿病程1个月以内104例和病程1个月以上41例的阳性率。结果 75只小鼠病理检查结果有心肌炎改变占85.3%，CVB-RNA阳性率为53.3%。145例患儿CVB-RNA阳性率为46.2%。PCR CVB-RNA病程1个月以内阳性率为56.7%，显著高于病程1个月以上(阳性率为26.8%)。结论 用PCR技术检测病毒性心肌炎血中CVB-RNA的敏感性与可靠性均较高，病程1个月以内阳性率高于1个月以上。

Objective To determine the diagnostic value of coxsackie virus B-RNA (CVB-RNA) assay by the PCR technique and to ident ify the viral pathogen of myocarditis. Methods CVB3 was injec ted into the abdominal cavity of 75 mice. The pathological examination and CVB-R NA assay by the PCR technique were done. CVB-RNA was measured by the PCR method in 145 children with myocarditis. The positive rates of CVB-RNA of 104 cases who se courses were within one month were compared with 41 cases whose courses were more than one month. Results Of the 75 mice, 64 (85.3%) had pathological change of myocarditis. CVB-RNA was positive in 40 out of the 75 mi ce (53.3%). The positive rate of CVB-RNA was 46.2% in the blood of the 1 45 patients with myocarditis. The positive rate of CVB-RNA in patients whose cou rses were within one month (56.7%) was higher than that of patients whose co urses were longer than one month (26.8%). Conclusions The sensitivity and reliability of CVB-RNA assay in the blood by the PCR technique t o indentify the viral pathogen of myocarditis are high. The positive rate is hig her in patients whose courses of illness within one month than whose more than o ne month.