病毒在扩张型心肌病发病中的作用  

Immunotherapy targeted autoantibody in patients with dilated cardiomyopathy

作　　者：付卿卿[1] 王雪楠[2] 袁璟[1] 程鹏[3] 廖玉华[1] 

机构地区：[1]华中科技大学同济医学院心血管病研究所,华中科技大学附属协和医院心内科,湖北武汉430022 [2]济宁医学院附属医院检验科,山东济宁272013 [3]山东省寄生虫病防治研究所中心实验室,山东济宁272033

出　　处：《中国热带医学》2007年第12期2274-2275,共2页China Tropical Medicine

摘　　要：目的探讨扩张型心肌病(DCM)的各致病因素,分析病毒在DCM发病中的作用。方法采用逆转录聚合酶链式反应(RT-PCR)检测患者血肠病毒RNA(Evs-RNA)、柯萨奇病毒(Cox-B)和巨细胞病毒(CMV)。对患者病史、诊治过程、随访结果进行回顾性分析。结果病毒阳性185例,占总人数的61.46%,其中Evs-RNA阳性119例,Cox-B阳性96例,CMV阳性53例。经过平均2.1年随访,平均左室舒张期末内径(LVEDd)62.2±8.4mm,平均左室射血分数(LVEF)43.69±11.53%,平均心胸比(CRT)0.57±0.09;与治疗前比较具有显著差异(P<0.05),NYHA心功能分级均改善Ⅰ～Ⅱ级。结论发病前病毒感染史是DCM主要的致病因素。早期针对病毒感染的免疫学治疗能够显著改善患者的心肌功能,提高其生活质量。应将病毒学检查作为扩张型心肌病的常规检查项目。Objective To analyze the etiology of dilated cardiomyopathy （DCM） and observe the effects of the immunotherapy on DCM. Methods The reverse transcription- polymerase chain reaction amplification assay （BT- PCR） was developed to detect blood EVs ribonucleic acid （ RNA ）, Coxsackie virus and cytomegalovirus, The evaluation included medical history and results of the follow - up. Results Virus RNA could be detected in 185 of 301 patients （61.46%） . After the medianfollow - up of 2.1 years, the patients gained one to two NYHA class, their ratio of coeur and thorax （CRT）, left ventricular end diastolic dimension（LVEDd） and left ventricular ejection fraction（LVEF） were significantly improved compared with that before treatment. Conchlsion Viral infection/autoirnmunity was the common causes of DCM. The early immunotherapy with dilthiazem and metoprolol aimed directly at virus infection could obviously improve the cardiac function and quality of life of the patients with DCM.

关 键 词：扩张型心肌病 病因 免疫治疗 自身抗体 

分 类 号：R542.2[医药卫生—心血管疾病]