扩张型心肌病活检心肌中肠道病毒RNA和穿孔素、颗粒酶B的表达及其与心肌病变的相关性

Expression of enterovirus RNA, perforin and granzyme B in the myocardium of dilated cardiomyopathy and their correlation with myocardial lesions

目的 探讨肠道病毒 (EVs)持续感染、穿孔素及颗粒酶B在扩张型心肌病 (DCM)发病机理中的作用。方法 用原位杂交和免疫组化方法检测了 19例DCM患者 (DCM组 )和 10例正常对照者 (对照组 )心肌中的EVsRNA及心肌浸润细胞中穿孔素和颗粒酶B的表达。结果 DCM组中 9例的心肌检测到了EVsRNA ,15例心肌浸润细胞中检测到穿孔素mRNA和颗粒酶B的表达 ,阳性细胞数分别为 ( 1.95± 0 .70 )、( 1.79± 0 .64)个 /高倍视野。对照组心肌中未检测到EVsRNA和穿孔素、颗粒酶B的表达。结论 心肌EVs持续感染、心肌浸润细胞中穿孔素和颗粒酶B的表达可能在DCM的发病中起了一定作用。

Objective To explore the role of enterovirus(EVs), perforin and granzyme B in the pathogenesis of dilated cardiomyopathy. Methods EVs RNA and the expression of perforin or granzyme B were measured by in situ hybridization or immunohistochemistry techniques in the myocardium of nineteen patients with dilated cardiomyopathy. Myocardial specimens by autopsy from 10 patients died of trauma were used as controls. HE stain was performed for routine pathological examination. The correlation of EVs RNA,perforin and granzyme B expression with the myocardial lesions was investigated. Results EVs RNA was detected in 15 of the 19 patients, semiquantative analysis showed no correlation of EVs RNA positive area with the myocardial lesions. Perforin and granzyme B were detected in the infiltrated cells of the myocardium in all the twelve patients with dilated cardiomyopathy. The number of positive cells were shown to be in good correlation with the abundance of inflammation foci, but no correlation with the myocardial interstitial fibrosis or EVs RNA. The heart specimens from controls were detected to be negative for EVs RNA, perforin or granzyme B. Conclusion Persistent enterovirus infection and the expression of perforin and granzyme B in the myocardium might play an important role in the pathogenesis of dilated cardiomyopathy.