Danesh J, Wong Y, Ward M, Muir J
Clinical Trial Service Unit and Epidemiological Studies Unit, Radcliffe Infirmary, Oxford OX2 6HE, UK.
Heart. 1999 Mar;81(3):245-7. doi: 10.1136/hrt.81.3.245.
To study possible associations between coronary heart disease and serological evidence of persistent infection with Helicobacter pylori, Chlamydia pneumoniae, or cytomegalovirus.
Population based, case-control study, nested within a randomised trial.
Five general practices in Bedfordshire, UK.
288 patients with incident or prevalent coronary heart disease and 704 age and sex matched controls.
High concentrations of serum IgG antibodies to H pylori were present in 54% of cases v 46% of controls, with corresponding results for C pneumoniae seropositivity (33% v 33%), and cytomegalovirus seropositivity (40% v 31%). After adjustments for age, sex, smoking, indicators of socioeconomic status, and standard risk factors, the odds ratios (95% confidence intervals) for coronary heart disease of seropositivity to these agents were: 1.28 (0.93 to 1.75) for H pylori, 0.95 (0.66 to 1.36) for C pneumoniae, and 1.40 (0.96 to 2. 05) for cytomegalovirus.
There is no good evidence of strong associations between coronary heart disease and serological markers of persistent infection with H pylori, C pneumoniae, or cytomegalovirus. To determine the existence of moderate associations between these agents and disease, however, larger scale studies will be needed that can keep residual confounders to a minimum.
研究冠心病与幽门螺杆菌、肺炎衣原体或巨细胞病毒持续感染的血清学证据之间可能存在的关联。
基于人群的病例对照研究，嵌套于一项随机试验中。
英国贝德福德郡的5家普通诊所。
288例新发或现患冠心病患者及704例年龄和性别匹配的对照者。
54%的冠心病患者血清中幽门螺杆菌IgG抗体浓度高，而对照者中这一比例为46%；肺炎衣原体血清阳性的相应结果为（33%对33%），巨细胞病毒血清阳性为（40%对31%）。在对年龄、性别、吸烟、社会经济状况指标和标准危险因素进行校正后，这些病原体血清阳性与冠心病的比值比（95%可信区间）分别为：幽门螺杆菌1.28（0.93至1.75），肺炎衣原体0.95（0.66至1.36），巨细胞病毒1.40（0.96至2.05）。
没有充分证据表明冠心病与幽门螺杆菌、肺炎衣原体或巨细胞病毒持续感染的血清学标志物之间存在强关联。然而，为了确定这些病原体与疾病之间是否存在中度关联，需要进行更大规模的研究，将残余混杂因素降至最低。
