克山病患者心肌中肠道病毒抗原VP1及其基因检测

摘要

目的 进一步探讨肠道病毒感染与克山病发病的关系。方法 应用免疫组织化学等方法对克山病患者心肌组织标本进行肠道病毒检测并与其他疾病进行对比。结果 在11例克山病患者中发现9例病毒结构蛋白VP1阳性，其中8例同时检测到病毒RNA；而8例缺血性心肌病仅3例VP1阳性，其中2例RNA也阳性。3例死于其他疾病患者未发现肠道病毒。结论 克山病患者心肌组织中不仅存在肠道病毒基因RNA，而且也有其表达的结构蛋白VP1，提示肠道病毒感染可能为克山病发病的主要原因之一。%Purpose To observe the relationship between enterovirual infection and pathogenesis of Keshan disease. Methods Three-stage immunoperoxidase staining procedure was used to investigate the expression of enteroviral VP1 in the tissue, whereas RNA from autopsy and explant myocardial tissue was tes-ted for the ppesence of enteroviral RNA using reverse transcription nested polywerase chain reaction (PCR). Results Enteroviral VP1 was detected in myocardium of 9/11 patients with Keshan disease and 3/8 patients with ischemic heart disesase. Positive PCR signals were found in myocardium of 8/11 patients with Keshan disease and 2/8 patients with ischemic heart disease. Positive signals of both enteroviral RNA and VP1 were seen in myocardium of 7/11 patients with Keshan disease and 2/8 patients with ischemic heart disease. No enteroviral RNA or VP1 were detected in one case of alcoholic cardiomyopathy, one vitriolic toxicosis and one cerebral trauma. Conclusions These results support the major pathogenic role for enteroviral infection in Keshan disease.