EB病毒感染对冠心病合并心力衰竭患者免疫功能和心肌纤维化的影响  

Influence of epstein-barr virus infection on immunologic function and myocardial fibrosis in patients with coronary heart disease complicated by heart failure

作　　者：贾正培 孙晶 任鸿坤 武云涛 Jia Zhengpei;Sun Jing;Ren Hongkun;Wu Yuntao(Department of Cardiology,People's Hospital,Inner Mongolia Autonomous Region,Hohhot 010010,China;不详)

机构地区：[1]内蒙古自治区人民医院心内科,呼和浩特010010 [2]解放军总医院第七医学中心老年医学科,北京100700

出　　处：《中国循证心血管医学杂志》2024年第12期1516-1519,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨EB病毒(EBV)感染对冠状动脉粥样硬化性心脏病(冠心病,CHD)合并心力衰竭(HF)患者免疫功能和心肌纤维化的影响。方法选取2019年1月至2022年12月于内蒙古自治区人民医院心内科诊治的CHD合并HF患者,采用逆转录聚合酶链反应(RT-PCR)检测血清EBV DNA载量,根据是否合并EB病毒感染分为EBV感染组(n=29)和未感染组(n=91)。比较不同心功能分级与EVB感染的关系,检测两组患者心肌纤维化指标[Ⅰ型前胶原羧基端肽(PⅠCP)、Ⅲ型前胶原氨基端肽(PⅢNP)、基质金属蛋白酶-2(MPP-2)、基质金属蛋白酶-9(MPP-9)]以及细胞免疫学功能指标(CD3+、CD4+、CD8+、CD4+/CD8+T细胞)水平,采用Pearson相关性分析血清EBV DNA载量与心肌纤维化指标和细胞免疫学功能指标的相关性。结果感染组患者心功能分级与EBV DNA载量呈正相关(r=0.564,P=0.002);感染组患者外周血PⅠCP、PⅢNP、MMP-9、MMP-2、CD8+水平明显高于未感染组,CD3+、CD4+及CD4+/CD8+水平明显低于未感染组,组间差异均有统计学意义(P<0.05);EBV DNA载量与PⅠCP、PⅢNP、MMP-9、MMP-2、CD8+水平呈正相关(r=0.439、0.544、0.435、0.422、0.489,P<0.05),与CD3+、CD4+、CD4+/CD8+水平呈负相关(r=-0.699、-0.757、-0.642,P<0.001)。结论EBV感染可能会抑制CHD合并HF患者细胞免疫功能,促进患者的心肌纤维化进展,进一步损伤心脏功能。Objective To discuss the influence of epstein-barr virus(EBV)infection on immunologic function and myocardial fibrosis in patients with coronary heart disease complicated by heart failure(CHD+HF).Methods CHD+HF patients were chosen from Department of Cardiology in People's Hospital of Inner Mongolia Autonomous Region from Jan.2019 to Dec.2022.The load of serum EBV DNA was detected by using reverse transcription polymerase chain reaction(RT-PCR).All patients were divided,according to EBV DNA detection results,into infection group(n=29)and non-infection group(n=91).The relationship among different grades of heart function classification and EBV infection was analyzed.The indexes of myocardial fibrosis[type I procollagen carboxy-terminal peptide(PICP),type III procollagen N-terminal peptide(PIIINP),matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9)]and cellular immunology function indexes(CD3+,CD4+,CD8+,CD4+/+CD8 T cells)were detected in 2 groups.The relationship among EBV DNA load,indexes of myocardial fibrosis and indexes of cellular immunological function were analyzed by using Pearson correlation analysis.Results The grades of heart function classification were positively correlated to EBV DNA load(r=0.564,P=0.002)in infection+group.The levels of PⅠCP,PⅢNP,MMP-9,MMP-2 and CD8 were significantly higher,and levels of CD3+,+CD4 and CD4+/CD8+were significantly lower in infection group than those in non-infection group(P<0.05).EBV DNA+load was positively correlated to levels of PⅠCP,PⅢNP,MMP-9,MMP-2 and CD8(r=0.439,r=0.544,r=0.435,r=0.422,r=0.489,P<0.05),and negatively correlated to levels of CD3+,+CD4 and CD4+/CD8+(r=-0.699,r=-0.757,r=-0.642,P<0.001).Conclusion EBV infection can possibly inhibit cellular immunological function,improve myocardial fibrosis progression,and further damage heart function in CHD+HF patients.

关 键 词：冠心病 心力衰竭 EB病毒 心肌纤维化 细胞免疫学功能 

分 类 号：R541.4[医药卫生—心血管疾病]