巨细胞病毒感染与冠心病重症患者血液流变学和内毒素水平及预后的关系

Relationship between cytomegalovirus infection and hemorheology,endotoxin level and prognosis in patients with severe coronary heart disease

目的探讨巨细胞病毒(CMV)感染与冠心病(CHD)重症患者血液流变学、内毒素水平及预后的关系。方法回顾性分析2019年6月-2021年6月在医院诊治的103例CHD重症患者的临床资料,采用荧光定量聚合酶链式反应(qPCR)检测外周血中的CMV DNA,根据检测结果分为感染组(n=32)和未感染组(n=71)。比较两组患者的基础资料,分析两组患者血液流变学(高切全血黏度、中切全血黏度、低切全血黏度、血沉、血细胞比容)、血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、内毒素水平和预后不良事件,采用Spearman相关性分析CMV病毒载量与CHD重症患者血液流变学指标及内毒素水平的相关性。结果感染组血液流变学、血脂(TC、TG、LDL-C)、内毒素水平高于未感染组,HDL-C水平低于未感染组,差异均有统计学意义(P<0.05);CMV病毒载量与血液流变学、血脂(TC、TG、LDL-C)、内毒素水平呈正相关(P<0.05),与血脂(HDL-C)水平呈负相关(P<0.05);感染组不良预后不良事件发生情况高于未感染组(P<0.05)。结论CMV感染与CHD重症患者血液流变学、内毒素水平呈正相关,且感染患者更易出现不良预后。

OBJECTIVE To explore the relationship between cytomegalovirus(CMV)infection and hemorheology,endotoxin level and prognosis inpatients with severe coronary heart disease(CHD).METHODS A retrospective analysis was performed on the clinical data of 103 patients with severe CHD treated in the hospital between Jun 2019 and Jun 2021.The peripheral blood CMV DNA was detected by quantitative polymerase chain reaction(qPCR)assay.According to the detection results,they were divided into the infection group(n=32)and non-infection group(n=71).The basic data between the two groups were compared.The hemorheology(including high-shear whole blood viscosity,moderate-shear whole blood viscosity,low-shear whole blood viscosity,erythrocyte sedimentation rate and hematocrit),blood lipid,including total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C),endotoxin and prognosis in both groups were analyzed.The correlation between CMV load and hemorheology indexes and endotoxin levels was analyzed by Spearman correlation analysis.RESULTS The levels of hemorheology,blood lipid(TC,TG,LDL-C)and endotoxin in the infection group were significantly higher than those in the non-infection group,while HDL-C level was significantly lower than that in the non-infection group(P<0.05).CMV load was positively correlated with levels of hemorheology,blood lipid(TC,TG,LDL-C)and endotoxin(P<0.05),while negatively correlated with HDL-C level(P<0.05).The incidence of poor prognosis in the infection group was higher than that in the non-infection group(P<0.05).CONCLUSION CMV infection is positively correlated with levels of hemorheology and endotoxin in patients with severe CHD,which can lead to poor prognosis more likely.