进展性卒中与疱疹病毒感染相关性临床研究

目的 :探讨进展性卒中 (SIP)的临床特点及与人疱疹类病毒感染的相关性 ,为 SIP的临床诊治提供依据。方法 :对 47例 SIP患者进行 CT、 MRI、MRA、 DSA及颈动脉超声检查 ,分析影像学和临床特征 ;采用金标斑点法检测静脉血清人巨细胞病毒 (HCMV)和人疱疹病毒 (HSV) Ig M,并与非脑血管病患者组 (193例 )进行比较 ;用免疫组化方法检测骨髓细胞中的 HCMV基质蛋白 PP6 5抗原 ;加用磷甲酸钠 (PFA)抗病毒治疗 ,观察疗效。结果 :SIP患者 CT显示的脑梗死灶 90 .91%位于不同脑叶皮质、皮质下 ,呈单发或多发性不规则小斑片状低密度影 ;全部受检者均存在脑供血主要动脉或主要分支的狭窄或闭塞 ;HCMV和 HSV Ig M阳性率 90 .91%,与对照组比较有显著性差异 (P<0 .0 1) ;加用抗病毒药物 (PFA)疗效显著。结论 :脑 CT显示皮质、皮质下不规则小斑片状脑梗死灶 ,脑主要供血动脉或 /和主要分支狭窄或闭塞 ,是 SIP的影像学特征 ;结合抗病毒药物治疗疗效显著 ;SIP与人疱疹病毒感染明显相关。

Clinical study on the relation between SIP and the infection in HSV

Objective: To explore the relationship between clinical characteristics of progressive stroke and herpes virus (HSV) infection, providing the clues to the diagnosis and treatment of progessive stroke. Methods: 47 patients with progressive stroke were detected and analysised by CT, MRI, MRA, DSA and carotid ultrasonic tomography. The levels of IgM of HCMV and HSV inserum of 47 patients with progressive stroke and 193 patients with non-cerbrovascular disease were deteceted by dot immunogold labeling staining (IGLS). To detect stromatin PP65 antigen of HCMV in marrow cell by immuno-histochemistry to observe the effect of antigent by Phosphonoformic Acid (PFA). Result: ①By CT infarctive lesions, single or multiple irregular small dot low-density plaques in cortex or subcortex of cerebral lobes, were found in 90.91% patients with progressive stroke. ②All patients had stenosis or occlusion in cerbral arteries or major branches. ③IgM of HCMV and HSV was found psoitive in 90.91% patients and the level of IgM in patients was significantly higher than that of controls (P<0.01). ④It is useful in the treatment by PFA. Conclusion: ①Irregular small infarctive legions in cortex or subcortex of cerebral lobes, and stenosis or occlusion in cerebral arteries or major branches suggest neuoradiological features of progressive stroke. ②It is useful in the treatment by antivirus druggery. ③There is a relationship between HSV infection and progressive stroke.