脑卒中患者血清中的肺炎衣原体抗体和超敏C-反应蛋白  

Serum chlamydia pneumoniae antibodies and high-sensitive C-reactive protein in patients with stroke

作　　者：刘爱民[1] 徐坚[2] 余竹元[3] 

机构地区：[1]复旦大学附属金山医院神经内科,上海市200540 [2]复旦大学附属金山医院职防科,上海市200540 [3]复旦大学附属中山医院内科免疫室,上海市200032

出　　处：《中国临床康复》2006年第38期85-87,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析脑卒中患者血清中肺炎衣原体抗体、超敏C-反应蛋白与脑卒中发病的关系及其临床意义。方法:选择2002-03/2006-02在金山医院神经科病房及门诊就诊的脑卒中患者80例作为脑卒中组,符合1995年脑血管疾病分类及诊断标准;同时选择80例未患脑卒中的健康人或医院内其他与脑血管疾病无关的患者作为对照组,其性别、种族、居住地与脑卒中组患者相匹配,两组观察对象均自愿参加观察。应用微量免疫荧光法检测两组观察对象血清中肺炎衣原体抗体(IgA,IgG),用胶乳增强免疫比浊法检测血清中超敏C-反应蛋白水平,用免疫比浊法检测血清总胆固醇、三酰甘油水平,并比较两组的差异。评估标准:肺炎衣原体-IgA阳性为滴度≥1∶16;肺炎衣原体-IgG阳性为滴度≥1∶64;超敏C-反应蛋白浓度在3mg/L以上被认为异常;总胆固醇超过5.7mmol/L为高胆固醇血症,三酰甘油超过1.7mmol/L为高三酰甘油血症。结果:纳入脑卒中组及对照组各80例,全部进入结果分析,无脱落。①两组观察对象血清肺炎衣原体-IgA,IgG的阳性检出率比较:脑卒中组肺炎衣原体-IgA阳性检出率显著高于对照组(73.8%,38.8%,P<0.01)。脑卒中组与对照组肺炎衣原体-IgG阳性检出率比较差异无显著性意义(55.0%,43.8%,P>0.05)。②两组观察对象血清超敏C-反应蛋白、血脂水平比较:脑卒中组血清超敏C-反应蛋白及总胆固醇水平均显著高于对照组[(6.75±0.25,2.32±0.18)mg/L;(5.64±0.72,4.32±0.68)mmol/L,P<0.01,0.05];两组血清三酰甘油水平相比差异无显著性意义[(1.82±0.73,1.61±0.68)mmol/L,P>0.05]。结论:高滴度的肺炎衣原体-IgA加上超敏C-反应蛋白水平升高可能是脑卒中危险的预兆物,而胆固醇是较三酰甘油更为密切地致动脉粥样硬化的危险因子。AIM： To analyze the relationship between the prevalence of stroke and serum chlamydia pneumoniae antibodies and high-sensitive C-reactive protein （Hs-CRP） in patients with stroke as well as its clinical significance. METHODS： Eighty stroke inpatients and outpatients between March 2002 and February 2006 were selected from the Department of Neurology of Jinshan Hospital and taken as the stroke group, who were in accordance with the classification and diagnostic criteria of cerebrovascular disease in 1995. Meanwhile, 80 healthy people without stroke or patients without eerebrovascular disease were taken as the control group, whose sex, race and residence matched with those of stroke patients. Subjects in both groups all participated in the experiment voluntarily. The microimmunofluorescence was used to detect the serum chlamydia pneumoniae （IgA, IgG） of subjects, and the Hs-CRP was measured by latex-enhanced turbidometry. The levels of serum total cholesterol CTC） and triacylglycerol were compared between the two groups. Criteria for evaluation： Positive in chlamydia pneumoniae-lgA as the tite≥ 1：16. Positive in chlamydia pneumoniae-lgG as the tite ≥ 1：64. Abnormal as the Hs-CRP above 3 mg/L. hypercholesteremia （HC） as the TC above 5.7 mmol/L. Hypertriacylglycerolemia as the triacylglycerol over 1.7 mmol/L. RESULTS： Eigh. ty patients in the stroke group and eighty subjects in the control group were involved in the analysis of results, and no one withdrew from the study. ①Comparison in the positive detection rate of serum chlamydia pneumoniae-lgA and lgG： the detection rate of lgA was significantly higher in the stroke group than that in the control group （73.8%, 38.8%, P 〈 0.01）, and there was no significant difference in detection rate of IgG between the two groups （55.0%,43.8%,P 〉 0.05）.② Comparison in the serum concentrations of Hs-CRP and blood lipid： the levels of Hs-CRP and TC were obviously higher in the stroke group than those in the control group [（6.7

关 键 词：脑血管意外 衣原体 肺炎 荧光免疫测定 C反应蛋白质 

分 类 号：R742[医药卫生—神经病学与精神病学]