病毒性心肌炎CBV—lgM抗体与心功能的研究

目的：探讨病毒性心肌炎（VM）患血清CBV－lgM抗体与左室总射血分值（EF）值及峰射血率（PER），峰充血率（PFR）的关系，以及心肌显像与心肌各局部EF值的关系。方法：对120例心肌炎患以ELISA法测CBV-lgM抗体，用^99mTc-MIBI心肌显像对其中37例行核素心室造影，测左室总体EF值及局部EF值，并测其PER和PFR；设正常对照40例。结果：（1）：CBV－lgM抗体阳性120例中有VM85例（70．83％），对照组仅2例（5％），P＜0．01，（2）^99mTc-MIBI心肌断层显像异常120例中有VM105例（87．5％），对照组仅1例（2．5％），P＜0．01；（3）CBV－lgM抗体阳性与^99mTc-MIBI心肌显像VM异常符合率为78．95％；（4）CBV－lgM抗体阳性中37例核素心室造影测得左室总EF降低21例（56．7％）；（5）节段性EF值降低33例（89．19％）；（6）PER，PFR降低20例（54．05％）；（7）心肌显像异常与EF降低符合率89．19％；（8）37例核素心室造影测定；PER降低22例（59．46％），PFR降低21例（56．7％）；（9）各节段EF降低；侧壁（LAT）12例（33．43％），下壁（INF）15例（40．54％），心尖部（AP）12例（33．43％），下间隔（IN－SEP）24例（64．86％），室间隔（SEP）31例（83．78％），结论：病毒性心肌炎患血清CBV－lgM抗体水平与心肌显像和心功能有良好的相关性，有助于该病的诊断和预后判断。

lgM andheart function inpatients with virus myocarditis

Objective:To determine the relationships among serum antibody CBX|lgM and left ventricular ejection fraction(LVEF),PER,PFR,among the radionuclide angiography and EF of myocardial segments in patients with virus myocarditis(VM).Methods:The antibody CBV|lgM of 120 subjects with VM was measured by ELISA method.Patients underwent 99m Tc|MIBI myocardial perfusion imaging,in which the LVEF and ventricular contractive?diastolic functional parameter:PER,PFR were measured by cardiac blood pool imaging in 37 patients.Control group consisted from 40 subjects.Results:(1)In 120 cases of positive CBV|lgM 85 cases were VM patients(70 83%),while 2(5%) were VM patients in controls, P <0 01;(2)In 120 cases of abnormal myocardiography with 99m Tc|MIBI 105 cases(87 5%) were VM patients,while 1(2 5%) was VM paitent in controls, P <0 01;(3)The consistent rate of positive CBV|lgM and abnormal myocardiography with 99m Tc|MIBI was 78 95%;(4)Among 37 cases with positive CBV|lgM,21 patients(56 76%) showed decreased LVEF;(5)Thirty|three patients showed decreased subdivision EF(89 19%);(6) Twenty patients showed decreased PER,PFR(54 05%);(7)The consistent rate of abnormal myocardiography and decreased EF was 89 19%;(8) Twenty|two patients had decreased PER(59 46%) and 21 patients had decreased PFR(56 76%);(9) Subdivision EF decreased:LAT 12(33 43%),INF 15(40 54%),AP 12(33 43%),IN|SEP 24(64 86%),and SEP 31(83 78%).Conclusion:Serum antibody CBV|lgM and radionuclide angiography are greatly associated with the ventricular functional in VM,it may help for their diagnosis and prognosis evaluation.