病毒性心肌炎患儿微小病毒B19感染的近期研究  

A studay on parvovirus B19 infection in viral myocardial children lately

作　　者：郑岩[1] 

机构地区：[1]长春市儿童医院,吉林130051

出　　处：《中国优生与遗传杂志》2006年第10期100-101,115,共3页Chinese Journal of Birth Health & Heredity

基　　金：长春市卫生局基金资助项目

摘　　要：目的进一步探讨病毒性心肌炎患儿微小病毒B19(HPVB19)感染的状况及其相关性。方法应用巢式聚合酶链反应的方法以及ELISA法,对60例病毒性心肌炎患儿(观察组)及30例随机挑选本院门诊健康体检儿童(对照组)血浆中微小病毒B19-DNA检测,同时进行B19-VP2-IgM检测。对观察组中HPCB19-DNA检测阳性的与阴性的两组中血CK、CK-MB及心功能指标进行比较。统计方法采用χ2和t检验。结果60例观察组,16例B19-DNA检测阳性,30例健康儿童B19-DNA检测均为阴性,阳性检出率为26.7%(16/60),两组比较有显著差别(P<0.01);60例观察组,B19-VP2-IgM阳性25%(15/60),对照组30例均为阴性极显著(P<0.01)。60例观察组中,B19 DNA及B19VP2 M均阳性15例;1例仅B19 DNA阳性;B19 DNA和B19 VP2 IgM同时阴性43例,B19 DNA和19-VP2-IgM一致率为93%,有一致性(P<0.01)。观察组中HPCB19-DNA检测阳性的与阴性的两组中血CK、CK-MB值变化无显著性差异,P>0.05。但心功能指标LVSF比较有明显差异(P<0.01),SV比较亦有明显差异(P<0.005)。结论小儿病毒性心肌炎与HPVB19感染有关,HPVB19是小儿病毒性心肌炎主要病原之一,而且本研究发现HPVB19感染所致小儿病毒性心肌炎的心功能改变中左室功能受累程度较重。Objective： To investigate the situation and relationship of microvirus B19 and viral myocarditis Lately. Methods： Sixty children with VMC serve as observing group, thirty normal children serve as control group. Using the nested -PCR detect microvirus B19 - DNA in plasma and ELISA was used to detect serum B19 VP2 IgM. In the observing group, we compared the data of CK, CK -MB in serum and cardiac function between theB19 - DNA positive and theB19 - DNA negtive group. Results： Of the observing group, sixteen cases is positive; the positive rate for B19 - DNA is 26. 7% ; of the control group, no one is positive. There are significant difference between the two groups （ P 〈0. 01 =. Of the observing group, 15 cases is positive; the positive rate for B19 VP2 IgM is 25%, of the control group, no one is positive. There are significant difference （ P 〈0. 01 ）. Crude agreement between the detecting results of B19 DNA and B19 VP2 IgM was 93%. They were significantly consistent. Of the observing group, the data of CK, CK - MB of the HPVB19 -DNA positive group and negtive group, is non -significant. But the cardiac function, especially the left ventricular dysfunction is obvious difference. The data of LVSF and SV of the HPVB19 - DNA positive group and negtive group is significant. LVSF （ P 〈0. 01 = , SV （ P 〈0. 005 =. The comparison of the cardiac function show that ventricular contraction function in the HPVB19 -DNA positive group is higher than the negtive group; all those results show the patients with viral myocarditis infected bv HPVB19 are more severely in left ventricular dysfunction. Conclusion： The infection of HPVB19 may be an important factor for myocarditis and more attention should be paled to it clinically.

关 键 词：病毒性心肌炎 微小病毒B19感染 酶联免疫吸附试验 巢式聚合酶链反应 

分 类 号：R725.4[医药卫生—儿科]