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肺炎衣原体和巨细胞病毒感染对冠状动脉疾病患病率及病程的影响

[Influence of Chlamydia pneumoniae and cytomegalovirus infections on prevalence and the course of coronary artery disease].

作者信息

Kruk M, Przyłuski J, Deptuch T W, Dzielińska Z, Kadziela J, Podsiadły E, Siennicka J, Piotrowski W, Kańtoch M, Tylewska-Wierzbanowska S, Ruzyłło W

机构信息

Klinika Kardiologii Ogólnej i II Samodzielna Pracownia Hemodynamiki.

出版信息

Pol Arch Med Wewn. 2001 Jan;105(1):39-44.

Abstract

Chlamydia pneumoniae (C. pneumoniae) as well as cytomegalovirus (CMV) are common pathogens found in about 50% of healthy western population. Many studies suggest a role of C. pneumoniae in development of coronary artery disease (CAD). CMV infection is also considered to increase risk of developing of CAD as well as restenosis after percutaneous coronary revascularization (PCI). The aim of our study was to evaluate a possible role of C. pneumoniae and CMV infections in both CAD development and course in patients (pts) undergoing PTCA. We enrolled 105 pts (mean age 56.4 years, 83 males) with angiographically documented CAD. Control group consisted of 63 healthy controls (mean age 47.25 years; 31 males). The study subjects were evaluated for presence of C. pneumoniae specific IgG antibodies (MIF test--MRL Diagnostic, USA; seroprevalence assumed when titre > or = 1/8). In 58 random PCI pts CMV specific IgG antibodies (ELISA Eti-Cytok-G PLUS--Dia Sorin) were evaluated. Pts were sampled at the time of PTCA. All PCI pts were assessed by angina questionnaire 5.9 +/- 2.6 months (mo) after the procedure with respect to clinical restenosis. C. pneumoniae IgG antibodies were detected in 37.1% of pts and in 22% of healthy controls (p < 0.05). After logistic regression was applied trend towards more frequent occurrence of C. pneumoniae specific IgG in CAD pts was shown (p = 0.10 OR = 2.4; 95% CI: 0.8-6.8). No significant correlation was found between anti-C. pneumoniae IgG presence or anti-CMV IgG titre and coronary atherosclerosis advancement. There was no significant difference in anti-CMV IgG titre between 9 pts who developed clinical restenosis 5.9 +/- 2.6 mo after PCI and the remaining pts. Our study results suggest a possible significant correlation between C. pneumoniae with CAD prevalence. We did not find a positive association of either infection markers with coronary atherosclerosis advancement. We did not find correlation of clinical restenosis after PCI with markers of CMV infection.

摘要

肺炎衣原体(C. pneumoniae)以及巨细胞病毒(CMV)是常见病原体,在约50%的西方健康人群中都能发现。许多研究表明肺炎衣原体在冠状动脉疾病(CAD)的发生发展中起作用。CMV感染也被认为会增加CAD的发病风险以及经皮冠状动脉血运重建术(PCI)后再狭窄的风险。我们研究的目的是评估肺炎衣原体和CMV感染在接受经皮腔内冠状动脉成形术(PTCA)的患者CAD发生发展过程中的可能作用。我们纳入了105例经血管造影证实患有CAD的患者(平均年龄56.4岁,男性83例)。对照组由63名健康对照者组成(平均年龄47.25岁;男性31例)。对研究对象检测肺炎衣原体特异性IgG抗体(微量免疫荧光试验——美国MRL Diagnostic公司产品;当滴度≥1/8时判定为血清阳性)。在58例随机选取的接受PCI的患者中检测CMV特异性IgG抗体(酶联免疫吸附测定法Eti-Cytok-G PLUS——Dia Sorin公司产品)。患者在PTCA时进行采样。所有接受PCI的患者在术后5.9±2.6个月通过心绞痛问卷评估临床再狭窄情况。37.1%的患者检测到肺炎衣原体IgG抗体,健康对照者中这一比例为22%(p<0.05)。应用逻辑回归后显示CAD患者中肺炎衣原体特异性IgG更频繁出现的趋势(p = 0.10,比值比=2.4;95%可信区间:0.8 - 6.8)。未发现抗肺炎衣原体IgG的存在或抗CMV IgG滴度与冠状动脉粥样硬化进展之间存在显著相关性。在PCI术后5.9±2.6个月发生临床再狭窄的9例患者与其余患者之间,抗CMV IgG滴度无显著差异。我们的研究结果表明肺炎衣原体与CAD患病率之间可能存在显著相关性。我们未发现任何一种感染标志物与冠状动脉粥样硬化进展呈正相关。我们未发现PCI术后临床再狭窄与CMV感染标志物之间存在相关性。

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