2018

150 руб.

Цитомегаловирусная инфекция и функции эндотелия у пациентов с острым инфарктом миокарда

Лебедева А. М.1, Марюхнич Е. В.1, Гривель Ж.‑Ш.2, Никитская Е. А.1, Албакова Т. М.1, Албакова Р. М.1, Рыжкова Е. В.1, Шпектор А. В.1, Марголис Л. Б.2, Васильева Е. Ю.1
1 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А. И. Евдокимова» Минздрава России, Москва
2 Национальный Институт Детского Здоровья и Развития Человека им. Юнис Кеннеди Шрайвер Национальных Институтов Здоровья, Мэриленд, США

Ключевые слова: острый инфаркт миокарда, вирус герпеса, цитомегаловирус, функция эндотелия

DOI: 10.18087/cardio.2018.7.10155

Цель исследования. Изучение связи активной цитомегаловирусной (ЦМВ) инфекции с дисфункцией эндотелия у пациентов с острым инфарктом миокарда (ОИМ). Материалы и методы. В исследование вошли 42 добровольца без ишемической болезни сердца (ИБС) и 63 пациента с ОИМ. У пациентов до коронарографии и у добровольцев при поступлении брали образцы крови для анализа дезоксирибонуклеиновой кислоты (ДНК) ЦМВ в плазме методом полимеразной цепной реакции в реальном времени. Кроме того, у пациентов с ОИМ и добровольцев без ИБС анализировали функцию эндотелия с помощью теста эндотелийзависимой вазодилатации (ЭЗВД) плечевой артерии. Результаты. Мы показали, что у пациентов с ОИМ при поступлении статистически значимо повышена концентрация ДНК ЦМВ в плазме крови по сравнению с таковой у добровольцев без ИБС, что отражает активную ЦМВ-инфекцию – 1185,7 (0; 3003,0) против 0 (0;910,8) копий ДНК/мл плазмы (p=0,011). При этом по сравнению с добровольцами без ИБС у пациентов с ОИМ также выявлена дисфункция эндотелия – 11,5 (7,5; 15,2) % против 4,4 (0; 9,6) % случаев (p<0,0001), которая достоверно коррелировала с активностью продукции ЦМВ (R= –0,35; p=0,002). Обсуждение. У пациентов с ОИМ помимо нарушения функции эндотелия в острую фазу заболевания также выявляется повышенная продукция цитомегаловирусной ДНК. В настоящей работе мы впервые выявили отрицательную корреляцию между активностью цитомегаловирусной инфекции и эндотелийзависимой вазодилатацией не только у здоровых добровольцев, но и у пациентов с ОИМ. Выявленная нами взаимосвязь между активацией ЦМВ и нарушением функции эндотелия может объяснять роль цитомегаловируса в развитии осложнений атеросклероза за счет активации и повреждения инфицированных им клеток эндотелия. Выводы. В настоящей работе мы подтвердили наличие дисфункции эндотелия и активной ЦМВ-инфекции у пациентов с ОИМ. Мы выявили отрицательную корреляцию между активностью ЦМВ-инфекции и ЭЗВД у добровольцев без ИБС и пациентов с ОИМ.
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Лебедева А. М., Марюхнич Е. В., Гривель Ж.‑Ш., Никитская Е. А., Албакова Т. М., Албакова Р. М., Рыжкова Е. В., Шпектор А. В., Марголис Л. Б., Васильева Е. Ю. Цитомегаловирусная инфекция и функции эндотелия у пациентов с острым инфарктом миокарда. Кардиология. 2018;58(7):41–52.

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