肺炎衣原体感染增加糖尿病患冠心病的危险性  

Chlamydia pneumoniae infection increases the risk of coronary artery disease in patients with diabetes

作　　者：孙余华[1] 鞠振宇[1] 吴永健[2] 裴卫东[1] 孙凯[1] 刘晓宁[1] 黄赞春[1] 张宇[1] 张惠丽[1] 陈纪林[2] 惠汝太 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院中德分子医学研究室,北京100037 [2]中国医学科学院中国协和医科大学阜外心血管病医院冠心病研究室,北京100037

出　　处：《中华心血管病杂志》2003年第3期169-172,共4页Chinese Journal of Cardiology

摘　　要：目的　本研究旨在探讨肺炎衣原体感染与冠心病的关系。方法　 142 2例冠状动脉造影证实有冠心病或急性心肌梗死的患者和 2 97例冠状动脉造影证实的非冠心病患者作为对照 ,应用ELISA方法检测血液中的肺炎衣原体 (chlamydiapneumoniae,Cp)特异性IgG抗体 (CpIgG)。所有个体分为有、无冠心病 ,有、无冠心病危险因素 (年老、男性、吸烟、糖尿病、血脂紊乱、高血压、CpIgG抗体阳性、较少体力劳动和体重指数 ) ,应用logistic回归分析 ,得出调整OR(比值比 )值 ,用于评估危险因素对冠心病的危险性。结果　冠心病患者组CpIgG阳性率 ( 31 1%)高于对照组 ( 2 4 9%) (P =0 0 35 ) ,但logistic回归分析显示 ,调整OR值为 1 2 95 ( 95 %CI:0 96 2～ 1 743 ,P =0 10 8) ,表明Cp感染与冠心病的发病关系不明显 ,而年龄≥ 5 5岁、男性、吸烟、高血压、糖尿病是冠心病的独立危险因素 ;进一步分组研究表明 ,CpIgG阳性组中 (n =5 16 ) ,糖尿病的调整OR值为 4 90 1( 95 %CI:1 44 9～ 16 5 81,P =0 0 1) ,而CpIgG阴性组 (n =12 0 3)调整OR值为 1 6 75 ( 95 %CI:0 988～ 2 841,P >0 0 5 ) ,表明Cp感染增加了糖尿病对冠心病的危险性 ;老年、男性和吸烟的调整OR值 ,CpIgG阳性组也高于CpIgG阴性组。结论　Cp感染与冠心病发病?Objective To investigate the correlation between Chlamydia pneumoniae(Cp)infection and coronary artery disease. Methods In this cross-sectional study, 1 422 patients with coronary artery disease (demonstrated either by angiography or acute myocardial infarction)and 297 controls with angiographical negativity were tested serologically for specific CpIgG antibody with ELISA. The risk factors for coronary artery disease were analyzed included aging, male. smoking, diabetes, hypertension, hyperlipidemia,mental labor (being higher socioeconomic status,but physical inactivity)and body mass index. The adjusted OR value was got for a given risk factor to be evaluated the risk for coronary artery disease by means of logistic regression analyisis. Results The prevalence of CpIgG seropositivity in patients with coronary artery disease was significantly higher than that in the controls (31.1% vs 24.9%, P=0.035), but only a weak association was got between CpIgG seropositivity and coronary artery disease after adjustment for confounding covariates, the adjusted OR was 1.295(95% CI, 0.962-1.743, P=0.108), and the adjusted ORs of aging (age over 65), male, smoking, hypertension, diabetes were significantly higher for coronary artery disease by logistic regression analysis. Further to investigate the role of CP seropositivity, all patients were grouped into two parts according to CpIgG seropositity or seronegativity, to compare the adjusted OR of a given risk factor for coronary artery disease in CP seropositive group(n=516) and CP seronegative group(n=1 203). In those with CpIgG seropositivity, adjusted OR of diabetes was much higher (4.901, 95% CI:1.449-16.581, P=0.01) than those with CpIgG seronegativity(adjusted OR1.675,95%CI:0.988-2.841, P>0.05). This indicated that CP infection could increase the risk of diabetes to the development of coronary artery disease. CpIgG seropositivity had the slighter increased risk in aging male and smoking cases for coronary artery disease, but little effect on the hypertensive cases.

关 键 词：肺炎衣原体 糖尿病 冠心病 心肌梗死 CP 

分 类 号：R541.4[医药卫生—心血管疾病]