肺炎衣原体感染对冠心病发病影响的临床观察  

Effect of Chlamydia Pneumoniae Infection Coronary Heart Disease

作　　者：刘柏年[1] 张我素[1] 梁爽霖[1] 

机构地区：[1]天津胸科医院心内科,天津300051

出　　处：《中国心血管杂志》2000年第3期146-149,共4页Chinese Journal of Cardiovascular Medicine

基　　金：天津市卫生局科研基金资助

摘　　要：目的 研究肺炎衣原体(Cpn)感染与冠心病(CHD)的关系.方法 应用酶联免疫吸附试验(ELISA)测定冠心病组(120例)和对照组(111例)血清Cpn特异性抗体IgM、IgG及IgA,同时应用免疫浊度法测定冠心病组(97例)和对照组(95例)血清C-反应蛋白(CRP)含量.结果 冠心病组血清Cpn抗体IgG和/或IgA阳性率及IgG和IgA滴度明显高于对照组(均P<0.05);急性心肌梗死(AMI)、不稳定型心绞痛(UAP)及慢性冠心病(CCHD)患者血清Cpn抗体IgG及IgA滴度均分别高于对照组(均P<0.05);冠心病组Cpn抗体IgM阳性率及滴度与对照组无明显差异;IgG和/或IgA及CRP均为阳性组的冠心病发生率明显增高;多元回归分析显示Cpn慢性感染与冠心病发病呈正相关(P=0.045),Cpn慢性感染与冠心病其他危险因素间无相关性.结论Cpn慢性感染可作为冠心病的独立危险因素,炎症反应的发生可能是Cpn慢性感染导致动脉粥样硬化的关键环节.Objective To investigate the association between Chlamydia pneumoniae (Cpn) infection and coronary heart disease (CHD). Methods serum IgM、IgG and IgA to Cpn were measured in 120 patients with CHD and in 111 healthy controls by enzyme-linked immunosorbant assay (ELISA) ,C-reactive protein was also measured. Results The rate of seropositivity for IgG and/or IgA and titer of IgG and IgA in CHD patients is significantly higher than those of controls (all P<0. 05) ;The titer of IgG and IgA for the patients with acute myocardial infarction (AMI)、unstable angina pectoris (UAP) and chronic coronary heart disease (CCHD) are significantly higher than those of controls (all P<0. 05);IgM seropositive rate and its titer in CHD patients are not significantly different compared with controls. Prevalence of CHD is significantly higher in subgroup with postive IgG and/or IgA and positive CRP:Multivariate regression analysis reveals that Cpn infection is positively related to CHD (P = 0. 045). No correlation was found between Cpn infection and other risk factors for CHD. Conclusion Chronic Cpn infection is an independent risk factor for CHD. Inflammatory response induced by Cpn chronic infection may be the critical step of atherosclerosis,development.

关 键 词：肺炎衣原体感染 冠心病 测定 酶联免疫吸附试验 血清C-反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病] R563.1[医药卫生—内科学]