低硒、氧化应激及CVB感染在克山病发病机制中的作用

目的　研究低硒、氧化应激和柯萨奇B组病毒 (CoxsackievirusB ,CVB)感染在克山病发病中的作用。方法　检测了陕西省黄陵县 30例潜在型、慢型克山病患者血清CVB IgM抗体、硒水平、总抗氧化能力以及脂质过氧化物 (LipidPeroxide,LPO)。健康对照选自黄陵县克山病病区和非病区西安市。结果　①克山病患者组CVB IgM阳性率显著高于病区和非病区健康组 ,分别为 43.3%vs 1 5 %和 43.3%vs 1 0 % ,P <0 .0 1 ;②克山病患者和病区健康居民血清硒水平和总抗氧化能力显著低于非病区西安人群 (P <0 .0 5 ) ,但克山病患者血清LPO水平显著高于两健康组 (P <0 .0 5 ) ;③克山病患者CVB IgM( + )者血清Se水平、总抗氧化能力显著低于CVB IgM( - )患者和病区健康组CVB IgM ( + )和CVB IgM ( - )者 (P <0 .0 5 ) ;克山病患者CVB IgM( + )血清LPO水平显著高于其他各组 (P <0 .0 5 )。结论　低硒、氧化应激与柯萨奇病毒感染可能与克山病的发生及发展有一定关系

The effects of selenium deficiency,oxidative stress,coxsackievirus B infection on the pathogenesis of Keshan disease

Objective To study the effects of selenium(Se) deficiency, oxidative stress and the infection of coxsackievirus B(CVB) on the pathogenesis of Keshan disease. Methods The serum CVB specific IgM,Se,total antioxidative ability and lipid peroxide(LPO) levels were measured.Thirty cases of latent and chronic type Keshan disease were selected from the endemic area Huangling County,Shaanxi Province. In control groups were healthy subjects from the endemic area Huangling County and the non endemic area Xi'an City, Shaanxi Province.Results ① The positive rate of CVB specific IgM in the patients was significantly higher than that of the control groups in Huangling County and Xi'an City(43.3% vs 15% and 43.3% vs 10%, P <0.01);②The serum Se and total antioxidative ability of patients and healthy controls in Huangling County were significantly lower than those of healthy controls in Xi'an ( P <0.05). However,the serum LPO of the patients was significantly higher than that of the two healthy control groups ( P < 0.05 );③ In CVB IgM positive patients, the serum Se level and total antioxidative ability were significantly lower than those of CVB IgM negative patients and CVB IgM(+) or CVB IgM(-) healthy group ( P <0.05),and the serum LPO level of CVB IgM(+) patients was significantly higher than that of the other groups( P <0.05).Conclusion CVB infection, Se deficiency and oxidative stress might be associated with the occurrence and development of Keshan disease.