慢性复发性心膜炎和扩张性心肌病:持续性肠道病毒感染的血清学证据
P Muir1, F Nicholson, A J Tilzey
1Department of Virology, United Medical School, Guy's Hospital, London.
Lancet (London, England)
|April 15, 1989
概括
持久性肠道病毒感染,特别是Coxsackie B病毒,在慢性心膜炎和扩张性心肌病患者的长期IgM反应中可见. 急性感染仅显示过渡性IgM抗体水平.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 心脏病学 心脏病学
背景情况:
- 肠道病毒感染与心膜炎和扩张性心肌病症有关.
- 持续性肠道病毒感染在慢性心脏病中的作用需要进一步阐明.
研究的目的:
- 在患有慢性复发性心膜炎和扩张性心肌病的患者中调查肠道病毒特异性IgM反应.
- 根据IgM抗体配置文件,区分急性和持续性肠道病毒感染.
主要方法:
- 利用两种IgM捕获试验检测肠道病毒特定的IgM抗体.
- 分析了急性心周炎,慢性复发心周炎和扩大心肌病的患者的IgM抗体水平和持久性.
- 在患有扩张性心肌病和IgM阳性的患者中检查了HLA类型.
主要成果:
- 在64%的慢性复发性心膜炎患者中检测到肠道病毒特异性IgM反应,持续长达10年.
- 患有急性心膜炎复发的患者的IgM抗体水平明显高于没有复发的患者.
- 33%的扩张性心肌病患者显示出IgM反应,在移植后持续长达4年.
- 在IgM阳性扩展性心肌病患者中观察到HLA A2单元型的更高频率.
- 在慢性心脏病患者中也注意到持续的病毒特异性血清IgA反应.
结论:
- 持续的肠道病毒感染,特别是Coxsackie B病毒,在慢性复发性心膜炎和扩张性心肌病症中是建议的.
- 长期的IgM抗体持久性是慢性肠道病毒感染的标志物,与急性病例的短暂反应形成鲜明对比.
- 在肠道病毒引起的扩张性心肌病中,HLA A2可能与敏感性或不同的免疫反应模式有关.
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