肠道病毒感染致暴发性致死性心肌炎

Outbreaks of fulminant myocarditis is caused by enterovirus infection

目的 探讨肠道病毒感染与云南省暴发性心肌炎病因学关系。方法 选用新建立的免疫组织化学方法对云南省死于暴发性心肌炎及非感染性疾病患者心肌组织进行肠道病毒抗原原位检测 ,同时用相同方法检测患者心肌组织中是否存在腺病毒、巨细胞病毒、乙型及丙型肝炎病毒。结果 10例死于心肌炎暴发流行期及 2例阳性对照患者心肌组织中均发现肠道病毒抗原存在 ,但死于其他疾病者未发现肠道病毒抗原 ,患者心肌组织中亦无其它致心肌炎病毒抗原存在。

Objective To establish the etiological relationship between enterovirus infection and outbreaks of fulminant myocarditis in Yannan Province.Methods Myocardial tissue samples from 10 patients who died during myocarditis outbreaks from July to August in different years in the Yunnan Province were collected to detect enterovirus capsid protein VP1 by an improved immunohistochemical method.Two patients with known enterovirus myocarditis and 4 cases who died of amniotic fluid embolism or drug intoxication from Yunnan Provine were served as positive or negative controls respectively.Tissue samples were also screened for antigens of adenoviruses,cytomegalovirus,hepatitis B and C vriruses.Results All of 10 cases with fulminant myocarditis were positive for enterovirus VP1.The positive signal was mainly localized in the cytoplasm of focal or sattered myocytes.Enterovirus VP1 was also positive in the 2 positive controls.No enterovirus VP1 staining was found in negative controls.Adenovirus,cytomegalovirus,hepatitis B or C viruses were not found in any of these cases.Conclusions The data of the present study suggest that enterovirus be the etiological agent of the outbreak of fulminat myocarditis in Yunnan Province.