肺炎衣原体感染与动脉血栓性脑梗塞的相关性研究  

Correlation of Chlamydia pneumoniae infection and stroke

作　　者：邹蓉 曾进胜[2] 赖颂辉 苏海芳 庞汉萱 

机构地区：[1]增城市人民医院,广东增城511300 [2]中山大学附一医院神经内科,广东广州510080

出　　处：《中国热带医学》2009年第5期794-795,共2页China Tropical Medicine

基　　金：广州市科委科研基金资助项目(2002J-C0183)

摘　　要：目的探讨肺炎衣原体(CPn)感染与动脉血栓性脑梗塞的关系。方法用酶联免疫吸附试验(ELISA)法测定脑血管病患者共246例:其中脑梗塞患者112例,脑出血106例,均经头颅CT或MRI检查证实;TIA患者28例。50例其他疾病患者的血清肺炎衣原体特异性IgG抗体及IgM抗体。结果肺炎衣原体慢性感染率分别为脑梗塞组85.71%(96/112)和对照组48%(24/50),脑梗塞患者肺炎衣原体慢性感染率均明显高于对照组,脑血管病组(包括脑梗塞及脑出血)肺炎衣原体慢性感染率为80.4%,明显高于对照组有统计学差异(P<0.01)。肺炎衣原体IgG阳性病例血清TG浓度明显高于肺炎衣原体IgG阴性的病例(P<0.05);HDL-C则明显低于阴性组。以克拉霉素治疗清除肺炎衣原体感染,观察其12月、18月、24月脑血管事件的发生率,表明其再发生率明显下降。结论脑梗塞患者肺炎衣原体感染率明显增高,提示肺炎衣原体感染可能与脑梗塞有关。其可能的机理是肺炎衣原体感染后形成免疫复合物沉积在血管壁,引起血管局部损伤;以及改变了血脂浓度来增加脑血管病发生的危险性。克拉霉素治疗清除肺炎衣原体感染对动脉血栓性脑梗塞有一定的预防作用。Objective To investigate the correlation of Chlamydia pneumoniae （CPn） infection and stroke. Methods Specific IgG and IgM antibdies to Chlamydia pneumoniae were determined by ELISA and concentrations of total cholesterol （TC）, triglyceride （TG） were measured in 246 patients with stroke and 50 controls with other diseases. Results Chlamydia pneumoniae infection rate was 85.71% in the cerebral infarction group ,75.47% in the intracerebral hemorrhage group and 48% in the control group. The prevalence of cerebral infarction group and cerebral hemorrhage group were higher than that in control group. Conclusion Chlamydia pneumoniae infection may be associated with stroke . Possible mechanism was that Chlamydia pneumoniae infection might modify the serum lipid concentrations in a way that could increase the risk of stroke.

关 键 词：肺炎衣原体 脑梗塞 动脉粥样硬化 克拉霉素 

分 类 号：R375.2[医药卫生—病原生物学]