柯萨奇B病毒性心肌炎、扩张型心肌病中病毒持续感染及中药干预的研究

Study on Continuous Infection by Virus in CVB Viral Myocardiopathy,Dilated Cardiomyopathy and Chinese Herbs Intervention

目的 :研究柯萨奇B病毒性心肌炎、扩张型心肌病中病毒持续感染与中药干预的相关性。方法 :建立急慢性病毒性心肌炎动物模型 ,用定性及定量多聚酶链反应测脾脏白细胞中以及心肌匀浆中的柯萨奇B病毒核糖核酸 (CVB -RNA) ;对急性病毒性心肌炎及扩张型心肌病的临床病例 ,用定性的方法定期检测外周血白细胞中CVB -RNA ,观察其病毒持续状态以及用原位PCR法检测扩张型心肌病心肌活检标本中CVB -RNA ,以明确病毒持续感染与扩张型心肌病的意义 ;观察苦参中抗柯萨奇B病毒的有效成分(SFA)干预的临床价值。结果 :1 8例扩张型心肌病病人有 6例病人的外周血白细胞中CVB -RNA (+) ,占 33 .3 % ,有的已持续 3年以上 ,其中 1 3例用原位PCR检测 ,有 6例心肌细胞中CVB -RNA(+) ,占 46 .2 % ,对慢性 (2 70d)病毒性心肌炎动物模型脾脏白细胞及心肌匀浆中定量检测 ,结果均证明有持续感染的存在 ,用SFA治疗后 ,在心肌匀浆中CVB -RNA的清除率为 92 .77% ,脾脏白细胞中CVB -RNA的清除率为 89.0 4 %。结论 :扩张型心肌病与病毒性心肌炎有相关性 ,扩张型心肌病与病毒持续感染有关 ,SFA能清除CVB -RNA达 89%～ 92 %。

Objective: To study on continuous infection by virus in CVB viral myocarditis,dilated cardiomyopathy and chinese herbs intervention.Methods:To examine CVB-RNA of spleen WBC and myocardium through myocarditis animal model.To examine CVB-RNA of peripheral blood WBC in acute viral myocarditis and dilated cardiomyopathy cases with qualitative analysis.To examine CVB-RNA of dilated cardiomyopathy specimen with PCR in situ.To observe clinical value of SFA.Results:There were 6 cases CVB-RNA(+) of peripheral blood WBC in 18 dilating myocardiopathy.The rate was 33.3%.CVB-RNA(+) of myocardium cell was 46.2%,There was continuous infection in chronic(270 days) vival myocarditis animal model throuth quantitative analysis.After treatment with SFA,clearance of CVB-RNA was 92.77% in myocardium and 89.04% in spleen WBC.Conclusion:Dilated myocardiopathy was relevant to viral and viral continuous infection.Clearance of SFA was 89%～92% to CVB-RNA.