Hannu T, Puolakkainen M, Leirisalo-Repo M
Department of Medicine, Helsinki University Central Hospital, Finland.
Rheumatology (Oxford). 1999 May;38(5):411-4. doi: 10.1093/rheumatology/38.5.411.
To determine the role of Chlamydia pneumoniae as a triggering infection in reactive arthritis (ReA).
Sixty patients with acute arthritis were screened for the evidence of triggering infections. In all patients, bacterial stool cultures, culture of Chlamydia trachomatis in urethra/cervix, and/or bacterial serology were studied. Chlamydia pneumoniae antibodies were measured by specific microimmunofluorescence test.
Thirty-five of 60 patients fulfilled the diagnostic criteria for ReA. Thirty-one patients had microbial/serological evidence of preceding infection due to Salmonella, Yersinia, Campylobacter or Chlamydia trachomatis, or they had enteritis or urethritis prior to arthritis. Four additional patients had high antibody titre for C. pneumoniae. Three of these four patients had preceding lower respiratory symptoms, and were positive for HLA-B27. The clinical picture of C. pneumoniae-positive ReA patients was similar to that of ReA patients with other definite aetiology.
Chlamydia pneumoniae is a triggering factor in approximately 10% of patients with acute ReA.
确定肺炎衣原体作为反应性关节炎（ReA）触发感染的作用。
对60例急性关节炎患者进行筛查，以寻找触发感染的证据。对所有患者进行了粪便细菌培养、尿道/宫颈沙眼衣原体培养和/或细菌血清学检查。采用特异性微量免疫荧光试验检测肺炎衣原体抗体。
60例患者中有35例符合ReA诊断标准。31例患者有微生物/血清学证据表明先前感染过沙门氏菌、耶尔森菌、弯曲杆菌或沙眼衣原体，或者在关节炎之前患有肠炎或尿道炎。另外4例患者肺炎衣原体抗体滴度较高。这4例患者中有3例先前有下呼吸道症状，且HLA - B27呈阳性。肺炎衣原体阳性的ReA患者的临床表现与其他明确病因的ReA患者相似。
肺炎衣原体是约10%急性ReA患者的触发因素。
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