柯萨奇病毒B3m重复感染致病毒性心肌炎的心脏形态学改变  

Morphological changes of heart in viral myocarditis caused by repetit ive infection of Coxsackievirus B3m

作　　者：郭玲[1] 孙辉[1] 钟翔宇[2] 王莹威 周令望[1] 钟学宽[1] 

机构地区：[1]哈尔滨医科大学克山病研究所,150086 [2]哈尔滨医科大学第二临床医学院 [3]黑龙江省中医药大学

出　　处：《中国地方病学杂志》2005年第3期278-280,共3页Chinese Jouranl of Endemiology

基　　金：国家自然科学基金资助项目(39670656)

摘　　要：目的探讨柯萨奇病毒B3m(CVB3m)重复感染致病毒性心肌炎的心脏形态学改变。方法用梯度倍增法连续4次经腹腔注射CVB3m病毒液感染昆明小鼠,分别于末次感染后10、30、60d处死动物,HE和VG染色观察心肌病变和纤维增生情况;免疫组化法检测心肌中Ⅰ、Ⅲ型胶原。结果(1)HE染色显示末次感染后10d心肌损伤严重,30d时仍可见小灶坏死,60d时未检出心肌的炎性损伤。(2)VG染色表明末次感染后10d心肌即出现较弱的胶原染色,30d时胶原明显可见,60d时心肌组织的胶原显著增加,心肌组织血管周围胶原面积(PCVA)和心肌胶原容积分数(CVF)均显著增加。(3)心肌胶原的免疫组化进一步显示心肌胶原的增加以Ⅰ型为主,Ⅲ型胶原在末次感染后10、30d未见表达,60d时表达量亦较少,而Ⅰ型胶原的表达与胶原染色结果基本一致。结论CVB3m重复感染可导致心肌纤维化和心室重构,使室壁僵硬而影响心脏的收缩和舒张功能,是心力衰竭发生的重要原因之一。Objective To investigate the morphological changes of heart i n viral myocarditis caused by repetitive infection of Coxsackievirus B3m(CVB3m). Methods 4-week-old mice were infected 4 times intraperitoneally with a time- dependent dose and killed at the 10,30 and 60 day after the final infection resp ectively to be examined the heart changes and collagen hyperplasia by HE, VG sta in and IHC. Results (1) Heart damage appeared very serious on the tenth day, e ven small necrotic foci occurred on the 30th day , but no injury of heart could be seen 2 months after the final infection. (2) Collagen appeared at the tenth d ay and there was much more collagen in the heart and increased PCVA, CVF index o n the 60th day. (3)The IHC of collagen demonstrated the collagenⅠhyperplasia wa s more obvious compared with collagen Ⅲ hyperplasia. Conclusions It strongly indicates that repetitive infection of CVB3m leads to heart fibrosis and ventri cular remodeling, which results in decreased systolic and diastolic function of heart.

关 键 词：柯萨奇病毒 病毒感染 心肌损伤 B3m 病毒性心肌炎 心脏形态 免疫组化法 

分 类 号：R542.21[医药卫生—心血管疾病] R512.4[医药卫生—内科学]