Espinola-Klein C, Rupprecht H J, Blankenberg S, Bickel C, Kopp H, Rippin G, Hafner G, Pfeifer U, Meyer J
2nd Department of Medicine, Johannes-Gutenberg University, Mainz, Germany.
Stroke. 2000 Sep;31(9):2127-33. doi: 10.1161/01.str.31.9.2127.
Chronic infection with Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus (CMV), and herpes simplex virus (HSV) has been implicated in the pathogenesis of atherosclerosis. The carotid intima-media thickness (IMT) can be taken to indicate early atherosclerosis, the presence of a carotid stenosis is a marker of a manifest carotid atherosclerosis, and an increase in arterial stiffness is used as marker of structural and functional changes in an atherosclerotic vessel wall.
In 504 patients (75% men; mean age 62.9 [SD 10] years), we measured the IMT and the elastic pressure modulus (EP; n=445) of the common carotid artery and the prevalence of a internal or external carotid artery stenosis. Blood samples were taken, and antibodies against C pneumoniae, H pylori, CMV, and HSV types 1 and 2 were evaluated. Statistical evaluation was performed with regression procedures and multivariate logistic regression analyses.
Seropositivity for C pneumoniae was an independent predictor for a combined end point of highest category of IMT and carotid artery stenosis (OR 1.8, 95% CI 1.1 to 3.1; adjusted) for IgG titers. Independently, CMV increased the risk for the combined end point (OR 1.7, 95% CI 1.1 to 2.8; adjusted) for IgG titers and for IgA titers (OR 2.3, 95% CI 1.1 to 4. 9; adjusted). We found a significant correlation between IgG antibodies against CMV and EP; HSV type 2 IgG titers were associated with IMT and carotid stenosis, but the latter results were no longer significant after adjustment. There was no association with H pylori or HSV type 1.
We found a significant association of IgG antibodies against C pneumoniae and CMV with early and advanced carotid atherosclerosis. CMV was also correlated to functional changes of the carotid artery, but this could not be confirmed after adjustment.
肺炎衣原体、幽门螺杆菌、巨细胞病毒（CMV）和单纯疱疹病毒（HSV）的慢性感染与动脉粥样硬化的发病机制有关。颈动脉内膜中层厚度（IMT）可用于指示早期动脉粥样硬化，颈动脉狭窄的存在是明显颈动脉粥样硬化的一个标志，而动脉僵硬度增加则被用作动脉粥样硬化血管壁结构和功能变化的一个标志。
在504例患者（75%为男性；平均年龄62.9[标准差10]岁）中，我们测量了颈总动脉的IMT和弹性压力模量（EP；n = 445）以及颈内或颈外动脉狭窄的患病率。采集血样，评估针对肺炎衣原体、幽门螺杆菌、CMV以及1型和2型HSV的抗体。采用回归程序和多因素逻辑回归分析进行统计学评估。
肺炎衣原体血清阳性是IMT最高类别和颈动脉狭窄联合终点的独立预测因素（IgG滴度的比值比[OR]为1.8，95%可信区间[CI]为1.1至3.1；校正后）。独立地，CMV增加了联合终点的风险（IgG滴度的OR为1.7，95%CI为1.1至2.8；校正后）以及IgA滴度的风险（OR为2.3，95%CI为1.1至4.9；校正后）。我们发现针对CMV的IgG抗体与EP之间存在显著相关性；2型HSV IgG滴度与IMT和颈动脉狭窄相关，但调整后后者结果不再显著。与幽门螺杆菌或1型HSV无关联。
我们发现针对肺炎衣原体和CMV的IgG抗体与早期和晚期颈动脉粥样硬化存在显著关联。CMV也与颈动脉的功能变化相关，但调整后无法证实这一点。
