Pieniazek P, Karczewska E, Stepień E, Tracz W, Konturek S J
Department of Cardiac and Vascular Disease, Collegium Medicum, Jagiellonian University, Cracow, Poland.
Med Sci Monit. 2001 Sep-Oct;7(5):995-1001.
Seroepidemiological, pathological and animal studies suggest that chronic infection with Chlamydia pneumoniae (Cp) may directly impact the development or progression of atherosclerosis and coronary heart disease. The aim of the present study was to determine the seroprevalence of Cp infection and markers of systemic inflammation in patients undergoing routine coronary artery examination and prior to heart revascularization.
The research involved 76 patients with severe CAD and 81 control patients with normal coronary circulation confirmed by coronary angiography. The presence of serum IgG and IgA antibodies to Cp and plasma interleukin-8 (IL-8) levels was measured by EIA test. Furthermore, the levels of plasma C-reactive protein, fibrinogen, total cholesterol, and triglycerides were measured in all patients.
Seropositivity to Cp was found in 60.5% for IgG and in 61.8% of cases for IgA with CAD patients, as compared to 26.0% and 29.5% in the controls (p<0.001), respectively. The levels of Interleukin-8, plasma fibrinogen, total cholesterol and triglycerides were significantly higher (p<0.001) in the CAD group, while C-reactive protein tended to have a higher value in patients with atherosclerosis than in the control group, although the difference was not significant.
Cp infection significantly increases the risk of CAD, usually requiring coronary bypass surgery or percutaneous coronary intervention as effective measures. It may also modify the levels of serum lipids, CRP and fibrinogen, increasing the risk of atherosclerosis. The strong correlation between the elevated IgG and IgA titers of Cp in patients treated with angioplasty or surgery may impact their follow-up; this issue requires further investigation.
血清流行病学、病理学及动物研究表明，肺炎衣原体（Cp）慢性感染可能直接影响动脉粥样硬化和冠心病的发生或发展。本研究旨在确定接受常规冠状动脉检查及心脏血运重建术前患者中Cp感染的血清流行率及全身炎症标志物。
本研究纳入76例经冠状动脉造影证实患有严重冠心病（CAD）的患者和81例冠状动脉循环正常的对照患者。采用酶免疫分析试验检测血清中抗Cp的IgG和IgA抗体以及血浆白细胞介素-8（IL-8）水平。此外，还测定了所有患者血浆C反应蛋白、纤维蛋白原、总胆固醇和甘油三酯水平。
CAD患者中，IgG对Cp的血清阳性率为60.5%，IgA为61.8%，而对照组分别为26.0%和29.5%（p<0.001）。CAD组白细胞介素-8、血浆纤维蛋白原、总胆固醇和甘油三酯水平显著更高（p<0.001），虽然差异不显著，但动脉粥样硬化患者的C反应蛋白水平往往高于对照组。
Cp感染显著增加CAD风险，通常需要冠状动脉搭桥手术或经皮冠状动脉介入作为有效措施。它还可能改变血脂、CRP和纤维蛋白原水平，增加动脉粥样硬化风险。接受血管成形术或手术治疗患者中Cp的IgG和IgA滴度升高之间的强相关性可能会影响其随访；这一问题需要进一步研究。
