在儿科心脏移植中,内皮功能障碍和细胞巨乳病毒复制
Jacob Simmonds1, Matthew Fenton, Catherine Dewar
1Department of Cardiology, Great Ormond Street Hospital for Children, Great Ormond St, London, WC1N 3JH, UK. simmoj@gosh.nhs.uk
Circulation
|May 14, 2008
概括
儿科心脏移植后细胞巨乳病毒 (CMV) 复制与全身内皮功能障碍有关. 这一发现表明,CMV可能会影响儿童的心脏移植之外的血管健康.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 移植免疫学 移植免疫学
- 血管生物学 血管生物学
背景情况:
- 心脏全移植血管病变是儿科心脏移植成功的主要限制.
- 细胞巨乳病毒 (CMV) 是已知的心脏全移植血管病变的风险因素.
- 白细胞中的CMVDNA表明,除了异种移植外,还有系统性血管效应.
研究的目的:
- 调查CMV复制与儿科心脏移植接受者的全身内皮功能之间的关联.
- 通过使用臂动脉流介导扩张来评估内皮功能,与移植后的CMV状态相关.
主要方法:
- 通过高分辨率超声波评估系统性动脉内皮功能,测量手臂动脉流量介导扩张.
- 研究了50名儿科心脏移植接受者 (8-17岁).
- 根据移植后的CMV复制状态分组患者 (n=38没有复制;n=12复制).
主要成果:
- 与没有CMV复制 (6.64+/-1.12%) 的儿童相比,CMV复制 (9.48+/- 0.56%;P=0.02) 的儿童的流媒体扩张显著受损.
- 这种损伤在调整年龄,移植后的时间和药物治疗后仍然存在.
- 移植前的CMV状态和传统的CMV风险因素与内皮功能无关.
结论:
- 移植后的CMV复制与儿科心脏移植接受者的全身循环中的慢性内皮功能障碍有关.
- 这表明CMV可能会导致这些患者的全身血管疾病.
- 需要进一步的前性研究来评估对全身和冠状动脉血管健康的影响.
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