慢性病毒性心肌炎抗体对预后的影响及早期干预的疗效

Influence on prognosis of anti-myocardial antibody of chronic viral myocarditis and effect of intervention earlier

目的:探讨抗心肌抗体在慢性病毒性心肌炎（VMC）向扩张性心肌病（DCM）转化过程中所起的作用及早期干预的疗效。方祛:通过计算机预测ADP/ATP载体蛋白（ANT）和β1受体抗原决定簇的氨基酸序列,用人工多肽合成仪器合成的多肽作为抗原.应用ELISA方法,对慢性VMC病人进行抗心肌抗体的检测,同时对其进行临床追踪观察及干预,并评价其疗效。结果:慢性VMC病人抗心肌抗体联合检测阳性率为80％;22例抗体阳性的慢性VMC患者经过3.1年随访,其中8例（36.4％）演变为DCM,经给予地尔硫(?)或倍他乐克干预治疗后6例恢复正常,而6例抗体阴性的患者随访期间均未出现DCM表现。结论:慢性VMC病人抗心肌抗体阳性率较高,部分患者会转化为DCM;药物干预治疗效果较好。

Objective; To explore the effect of anti-myocardial antibody in process of chronic viral myocarditis (VMC) converting into dilated cardiomyopathy (DCM) and the effect of intervention earlier. Methods-. Using the computer to forecast the amino acid sequence of antigenic determinant of ADP/ATP carrier (ANT) and Pi receptor, use the polypeptide synthesized by artificial polypeptide-synthesizing instrument as antigen, apply ELISA method to detect anti-myocardial antibody for chronic VMC patient. Clinical chasing observation and intervention were performed and its curative effect was appraised. Results: Positive rate of anti myocardial antibody in chronic VMC patients by associating detection was 80%; In 22 chronic VMC patients whose antibody were positive, 8 cases (36. 4%) were converting into DCM after 3.1 years. Six DCM patients return to normal after giving corresponding medicine (diltiazem or betaloc). Six patients whose antibody was negative did not arise DCM manifestation during follow-up with VMC observation. Conclusion: Positive rate of anti-myocardial antibody is higher in chronic VMC patient, some patients can convert into DCM, anti-myocardial antibody in the course of changing take important role; medicine therapy possess better curative effect.