柯萨奇病毒BRNA与中和抗体检测在病毒性心肌炎诊断中的意义  

The clinical value in detecting of CVB-RNA PCR and viral neutralization antibody for diagnosis viral myocarditis

作　　者：陈曙霞[1] 谢龙山[1] 梅尚文[1] 钱富荣[1] 陈美芳[1] 

机构地区：[1]上海第二医科大学附属仁济医院心血管内科,200001

出　　处：《中华检验医学杂志》2003年第3期166-168,共3页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金资助项目 ( 395 70 314 )

摘　　要：目的　探讨多重聚合酶链反应 (PCR)及微量中和抗体法诊断病毒性心肌炎 (MC)的价值。方法　用微量法和逆转录PCR法 ,检测 10 0 0例诊断为急 /慢性期MC患者和 37名正常人中的柯萨奇B病毒核糖核酸 (CVB RNA)与中和抗体水平 ,并进行比较性研究。结果　正常人CVB RNA及中和抗体均为阴性。在 10 0 0例MC患者中 ,CVB RNA阳性 346例 ( 34 6 %) ,其中急性期 2 45例占70 8%,慢性期 10 1例仅占 2 9 2 %。而中和抗体检测阳性及阴性各 5 0 0例 (均为 5 0 %)。在 6 5 4例CVB RNA阴性患者中 ( 6 5 4%) ,中和抗体阳性者 36 9例 ( 5 6 4%) ,其中慢性期 2 5 5例占 6 9 1%。急性期 114例占 30 9%。表明急性期CVB RNA阳性居多 ,慢性期中和抗体阳性居多。结论　在MC的不同阶段 ,CVB RNA和中和抗体的阳性率有所不同 ,同时进行 2项检测可提高诊断率。Objective To evaluate the diagnostic value of polymerase chain reaction (PCR) to detect CVB-RNA and serum neutralization assay for viral antibody in the different phase of viral myocarditis.Methods Using of microtechnique to detect serum neutralization antibody and PCR to detect CVB-RNA in 1 000 cases of viral myocarditis, where 442 cases in acute phase, 558 cases in chronic phase (including 18 cases of dilated myocardiopathy), and compare with of the results 37 normal control individuals.Results There were 346 patients got CVB-RNA positive in 1 000 MC cases (34.6%). Among them 245 cases in acute phase (70.8%), 101 cases in chronic phase only (29.2%). There were 500 patients got high titer serum neutralization antibody (50%). Among 1 000 MC patients there were 654 cases get PCR negative reaction (65.4%) and 369 cases got serum neutralization antibody positive 255 cases of 369 were in chronic phase (69.1%) 114 cases were in acute phase only (30.9%). Therefore it was indicated that the positive rate of CVB-RNA detection in acute phase was higher than of chronic phase. The positive rate of serum neutralization antibody detection in chronic phase was higher than that of in acute phase. Conclusion There were different positive rate of CVB-RNA PCR and serum neutralization antibody titer, in different phase of myocarditis. Detecting both antigen and antibody simultaneously could improve the diagnosis of viral myocarditis.

关 键 词：柯萨奇病毒B RNA 中和抗体 检测 病毒性心肌炎 微量法 逆转录PCR法 

分 类 号：R542.21[医药卫生—心血管疾病]