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目的探讨病毒性心肌炎早期快速病因诊断及病情评估的方法。方法130例心肌炎患者用免疫酶染色法测CBV-IgM抗体,微量板法测CBV中和抗体,并行99mTc-MIBI心肌显像;其中50例行平衡法核素心室造影测左心室功能。正常对照组40例。结果130例中,CBV-IgM抗体阳性68.5%,CBV中和抗体阳性63.8%,99mTc-MIBI心肌显像阳性80.8%,病例组50例平衡法核素心室造影测得左室总射血分数(EF)值降低21例(42.0%),节段EF值降低31例(62.0%),左室收缩功能(PER)降低22例(44.0%),左室舒张功能(PFR)降低23例(46.0%),室壁舒缩协调性下降18例(36.0%),以上各参数降低幅度与对照组比较,差异显著,P<0.01。比较分析显示,CBV-IgM抗体检测与中和抗体检测符合率为81.5%,99mTc-MIBI心肌显像与CBV-IgM抗体检测符合率为83.1%。左室总EF值或节段EF值下降与心肌放射性分布异常不均符合率为87.1%。结论免疫酶染色法测CBV-IgM抗体,结合核素心肌显像和心室造影,对病毒性心肌炎的病因诊断和病情评估有较高的价值。
Objective To explore the early diagnosis and diagnosis of viral myocarditis. Methods CBV-IgM antibody was detected by immunoenzyme staining in 130 patients with myocarditis. The neutralizing antibodies against CBV were detected by microplate method and 99mTc-MIBI myocardial imaging was performed. Fifty patients underwent cardiac biopsy with balanced method to measure left ventricular function. 40 cases of normal control group. Results Among the 130 cases, CBV-IgM antibody was 68.5%, CBV neutralization antibody was 63.8%, 99mTc-MIBI myocardial imaging was 80.8%, and 50 cases in the case group were balanced radionuclide ventriculography, 21 cases (42.0%) decreased EF, 31 cases (62.0%) decreased EF, 22 cases (44.0%) decreased left ventricular systolic function (PER) and 23 cases decreased left ventricular diastolic function (PFR) %), The systolic and diastolic coordination of the wall decreased in 18 cases (36.0%). The reduction of each parameter was significantly different from that in the control group (P <0.01). Comparative analysis showed that the coincidence rate of CBV-IgM antibody detection and neutralization antibody test was 81.5%, and the coincidence rate of 99mTc-MIBI myocardial imaging and CBV-IgM antibody test was 83.1%. The coincidence rate of left ventricular total EF or segmental EF and the abnormal myocardial radioactivity distribution was 87.1%. CONCLUSIONS: The detection of CBV-IgM antibody by immunoenzyme staining combined with radionuclide myocardial imaging and ventricular angiography is of high value in the etiological diagnosis and assessment of viral myocarditis.