在经皮冠状动脉血管成形术患者中进行的一项随机试验:罗红霉素不能减少临床再狭窄而血管成形术能增加抗肺炎衣原体抗体浓度  

A randomized trial in patients undergoing percutaneous coronary angioplasty: Roxithromycin does not reduce clinical restenosis but angioplasty increases antibody concentrations against Chlamydia pneumoniae

作　　者：Kaehler J Haar A Schaps K.-P. 王亭忠 

机构地区：[1]Department of Cardiology, University Hospital Hamburg, Martinistrasse 52, 20246 Hamburg, Germany,Dr.

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2006年第5期25-26,共2页

摘　　要：Background: Elevated antibodies against Chlamydia pneumoniae have been associated with coronary artery disease. In patients undergoing percutaneous coronary angioplasty, we therefore investigated the effect of roxithromycin on symptomatic restenosis and determined antichlamydial antibodies as well as inflammatory and immunological parameters. Methods: A total of 327 patients undergoing coronary angioplasty were randomized to roxithromycin or placebo and followed-up for 1 year. Antibodies were determined by microimmunofluorescence and enzyme-linked immunosorbent assay; C-reactive protein, interleukin-10, tumor necrosis factor-α (TNF-α ), and eotaxin were determined by enzyme-linked immunosorbent assay. Results: Although the frequency of restenosis was not affected by roxithromycin(25 restenoses vs 32 in the control group), antichlamydial antibodies increased during follow-up(anti-CP IgG + 12± 2% , P< .001). Concentrations of TNF-α and eotaxin increased as well(TNF-α + 9± 1% and eotaxin + 10± 2% )and correlated with antichlamydial antibody concentrations(TNF-α , r=0.23, P=.02; eotaxin, r=0.32, P=.002). Conclusions: Treatment with roxithromycin was not associated with a reduction of symptomatic restenoses. During follow-up, a marked increase in antichlamydial antibodies, TNF-α , and eotaxin was observed, suggesting that angioplasty-induced plaque rupture induces a specific immunological response without activation of inflammatory mechanisms as represented by C-reactive protein. Whether this mechanism occurs in all plaque ruptures remains to be determined.Background： Elevated antibodies against Chtamydia pneumoniae have been associated with coronary artery disease. In patients undergoing percutaneous coronary angioplasty, we therefore investigated the effect of roxithromycin on symptomatic restenosis and determined antichlamydial antibodies as well as inflammatory and immunological parameters. Methods： A total of 327 patients undergoing coronary angioplasty were randomized to roxithromycin or placebo and followed-up for 1 year. Antibodies were determined by microimmunofluorescence and enzyme-linked immunosorbent assay; C-reactive protein, interleukin-10, tumor necrosis factor-or （TNF-α）, and eotaxin were determined by enzyme-linked immunosorbent assay.

关 键 词：经皮冠状动脉血管成形术 抗肺炎衣原体 罗红霉素 抗体浓度 再狭窄 肿瘤坏死因子-α(TNF-α) 随机试验 患者 肺炎衣原体抗体 嗜酸性粒细胞趋化因子 

分 类 号：R654.2[医药卫生—外科学] R541.4[医药卫生—临床医学]