肺炎衣原体感染与脑梗死的关系  

Association between chlamydia pneumoniae infection and cerebral infarction

作　　者：刘建祥[1] 阎平建[2] 梅元武[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院神经科,湖北省武汉市430000 [2]郧阳医学院附属东风总医院神经科,湖北省十堰市442008

出　　处：《中国临床康复》2006年第14期94-97,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:检测脑梗死患者外周血单核细胞内的肺炎衣原体DNA,从血脂、吸烟量、高血压患病率等传统危险因素入手,分析肺炎衣原体感染与脑梗死的关系。方法:纳入2004-12/2005-03华中科技大学同济医学院附属协和医院脑梗死住院患者47例为观察组,男29例,女18例;非脑梗死患者48例,系同期在本院外科、妇产科住院的患者为对照组,男28例,女20例。用酶联免疫吸附试验法测定了两组患者的血清特异性抗肺炎衣原体IgG抗体及用聚合酶链反应检测两组患者外周血单核细胞内的肺炎衣原体DNA。比较两组患者的抗肺炎衣原体IgG抗体阳性率及血脂、吸烟量、高血压患病率等传统危险因素与脑梗死的关系。结果:实验组和对照组患者95例全部进入结果分析。①观察组抗肺炎衣原体IgG抗体阳性率明显高于对照组[78.7%(37/47例),37.5%(18/48例),χ2=16.555,P=0.000]。②用聚合酶链反应检测两组患者外周血单核细胞内肺炎衣原体DNA均为阴性。血清抗肺炎衣原体IgG抗体阳性病例血清胆固醇、三酰甘油、低密度脂蛋白及脂蛋白(a)浓度明显高于血清抗肺炎衣原体IgG抗体阴性病例[(5.4816±1.1917),(3.9965±0.8371)mmol/L;(1.6564±0.8644),(1.2365±0.7503)mmol/L;(3.2454±0.8918),(2.1815±0.7565)mmol/L;(379.96±220.31),(222.53±176.03)mg/L;t=2.469～6.758,P<0.05]。结论:①脑梗死患者肺炎衣原体感染率明显增高,肺炎衣原体感染与脑梗死有关,可能是脑梗死的一个重要危险因素,深入研究有可能探索出防治脑梗死的新途径。②用酶联免疫吸附试验法测定血清特异性抗肺炎衣原体IgG抗体的敏感性高,可用来判定肺炎衣原体感染。③用聚合酶链反应检测患者外周血单核细胞内的肺炎衣原体DNA阳性率太低,不适于用来判断有无肺炎衣原体感染。AIM： To detect the ehlamydia pneumoniae （Cp） DNA in the peripheral blood mnnonuclear cells （PBMCs） of patients with cerebral infarction, and analyze the association between the Cp infection and cerebral infarction via the traditional risk actors such as blood lipid, smoking, and the prevalence rate of high blood pressure. METHODS： Totally 47 inpatients with cerebral infarction treated at the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology between December 2004 and March 2005, including 29 males and 18 females, were selected as observation group; Other 48 inpatients including28 males and 20 females, treated simultaneously at Department of Surgery and Department of Obstetrics and Gynecology, were considered as control group. Cp-speeific IgG antibodies were measured in patients of both groups by enzyme linked immunosorbent assay. Polymerase chain reaction （PCR） was used to detect the Cp DNA in PBMCs of all the patients in both groups. The correlations of cerebral infarction with the positive rate of Cp-specific IgG and the traditional risk factors （including blood lipid, smoking and prevalence rate of high blood pressure, etc） were compared between the patients of both groups. RESULTS： Totally 95 patients were involved in the result analysis.（1） The positive rate of Cp-speeific IgG antibody was significantly higher in the observation group than in controls [78.7%（37/47）, 37.5%（18/48）, χ^2=16.555,P=0.000]. （2）Cp DNA in PBMCs of patients in both groups were detected as negative by PCR. The serum concentrations of total cholesterol, triacylglycerol, low density lipoprotein, and lipoprotein were significantly higher in the positive cases of Cp-speeific IgG than in the negative cases of Cp- specific IgG [（5.481 6±1.191 7）,（3.996 5±0.837 1） mmol/L;（1.656 4±0.864 4）, （1.236 5±0.750 3）mmol/L;（3.245 4±0.891 8）,（2.181 5±0.756 5） mmol/L; （379.96±220.31）,（222.53±176.03） mg/L;t=2.469-6.758,P 〈

关 键 词：衣原体 肺炎 酶联免疫吸附测定 IGG/分析 腑梗塞/病因学 

分 类 号：R742[医药卫生—神经病学与精神病学]