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病毒在心肌中的持久性与渐进的心脏功能障碍有关
Uwe Kühl1, Matthias Pauschinger, Bettina Seeberg
1Charite, Universitätsmedizin Berlin, Campus Benjamin-Franklin, Medizinische Klinik II, Abteilung für Kardiologie und Pneumologie, Hindenburgdamm 30, 12200 Berlin, Germany. uwe.kuehl@charite.de
Circulation
|September 21, 2005
概括
病毒性心脏感染,如肠道病毒和帕尔沃病毒B19,可以引起心肌炎. 自发性病毒清除改善了心脏功能,而持续性则使其恶化,提供了对病毒性心肌病进展的见解.
科学领域:
- 心脏病学 心脏病学
- 病毒学 病毒学
- 病理学 病理学 病理学
背景情况:
- 心脏型病毒感染与心肌炎和扩张性心肌病相关.
- 病毒性心脏病的自然进展在很大程度上是未知的.
- 以前的研究表明,扩张性心肌病患者的不良结果.
研究的目的:
- 为了研究病毒性心脏病的自然过程,使用内心肌组织活检.
- 为了确定病毒清除或持久性对左心室功能的影响.
- 分析心肌组织中特定心脏型病毒的清除率.
主要方法:
- 通过内肌心活检 (EMB) 分析了172名经过活检证明的病毒感染患者.
- 在平均6.8个月的随访后,重新分析EMB和血液动力学测量.
- 使用嵌套聚合酶链反应 (PCR) 和逆转录-PCR检测病毒基因组序列.
主要成果:
- 在EMB中检测到肠道病毒 (EV),腺病毒 (ADV),帕尔沃病毒B19 (PVB19) 和人类疹病毒6 (HHV6).
- 自发性病毒基因组清除发生在36.2%的单次感染患者中.
- 病毒清除与左心室喷射率 (LVEF) 的改善相关,而持久性导致LVEF降低.
结论:
- 这项研究提供了对病毒性心脏病进展的首次基于活检的分析.
- 病毒在心肌中的持久性与渐进的LVEF损伤有关.
- 自发性病毒消除与LV功能显著恢复有关.
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