病毒性心肌炎患儿微小病毒B19感染的研究

目的探讨病毒性心肌炎患儿微小病毒B19（HPV B19）感染的状况及其相关性。方法应用巢式聚合酶链反应法对60例病毒性心肌炎患儿（观察组）及30例健康体检儿童（对照组）血浆中微小病毒B19-DNA进行检测，并对观察组中HPV B19-DNA检测阳性与阴性两组中血CK、CK-MB及心功能指标进行比较。结果观察组B19-DNA检测阳性率为26．7％（16／60例），对照组B19-DNA检测均为阴性，两组比较差异有显著性（P〈0．01）。观察组中HPV B19-DNA检测阳性与阴性的两组中血CK、CK—MB值差异无显著性（P〉0．05）。心功能指标LVSF比较差异有显著性（P〈0．01），SV比较差异亦有显著性（P〈0．05）。结论小儿病毒性心肌炎与HPV B19感染有关，HPV B19可能是小儿病毒性心肌炎主要病原之一；HPV B19感染所致小儿病毒性心肌炎的心功能改变中左室功能受累程度较重。

Infection of human parvovirus B19 in children with viral myocarditis

Objective To investigate the incidence of human parvovirus B19 (HPV B19) infection and its correlation with viral myocarditis (VM) . Methods The detection of human parvovirus B19-DNA in plasma by nested-PCR and the determination of serum creatine kinase (CK) and MB isoenzyme of creatine kinase (CK-MB) were undertaken in 60 children with VM and 30 normal control children, respectively. The cardiac function was compared between positive and negative B19-DNA groups. Results The positive B19-DNA was confirmed in 16 cases of 60 children with VM (26. 7%) and none case in control group. There was a significant difference in the incidence of positive B19-DNA between two groups (P<0.01). No significant differences in the levels of either CK or CK-MB were observed between the positive- and negative B19-DNA in children with VM. However, the cardiac function in particular the incidence of left ventricular dysfunction including abnormal markers of LVSF (P<0.01) and SV(P<0.005) was significantly higher in children with positive B19-DNA than that in children with negative B19-DNA. Conclusions The HPVB infection that results in the change of cardiac function in particular the left ventricle function is involved prominently may play an important role in the pathogenesis of myocarditis in children.