Cai Xiao-jie, Cai Hua-bo, Lu Duan
Department of Cardiology, Sir Run Run Shaw Hospital, Hangzhou 310016, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2003 Jun;24(6):503-7.
Recently studies showed infections of Chlamydia pneumoniae (Cp), Helicobacter pylori (Hp) and cytomegalovirus (CMV) played roles in the development of atherosclerosis. The aim of this study was to study relationship between infection of Cp, Hp and CMV, systemic inflammation and coronary artery disease (CAD).
Fourty-five patients with at least one coronary artery stenosis > 50% and 33 control subjects with negative coronary angiography were recruited for this case-control study from May 2000 to October 2001. Antibodies against Cp, Hp and CMV were measured and serum C-reactive protein (CRP) levels determined for each case. CRP level > 0.8 mg/dl was defined at elevated CRP level.
The prevalence of Cp IgG, Hp IgG or Hp IgA antibody was associated with CAD (P = 0.017, P < 0.001, P = 0.009). After adjustment for age, gender, smoking, hypertension, hyperlipidemia and diabetes, the association was still seen. Mean CRP value was significantly higher in patients with CAD, compared to those without CAD (P < 0.001). Multivariate analysis showed statistical significance (P = 0.03). Elevated levels of CRP were found to be an important parameter for CAD (P = 0.032). The prevalence of Cp IgG antibody, Hp IgG and CMV IgG antibody all showed no association with elevated levels of CRP (P = 0.391, P = 0.253, P = 0.724). The ratio of elevated levels of serum basic CRP in the group with IgG antibodies to 3 pathogens was 32.1% while in the group with IgG antibodies to <or= 2 pathogens it was 14.9%. But with no significance difference between the two (P = 0.078).
Two chronic infections, Cp and Hp, might increase the risk of CAD. There was no association of CMV infection with CAD. C-reactive protein was an independent parameter of CAD, but the increased systemic inflammation in CAD did not seem to be related to aforesaid infection.
最近的研究表明，肺炎衣原体（Cp）、幽门螺杆菌（Hp）和巨细胞病毒（CMV）感染在动脉粥样硬化的发展中起作用。本研究的目的是探讨Cp、Hp和CMV感染、全身炎症与冠状动脉疾病（CAD）之间的关系。
2000年5月至2001年10月，选取45例至少有一处冠状动脉狭窄>50%的患者和33例冠状动脉造影阴性的对照者进行这项病例对照研究。检测每组病例针对Cp、Hp和CMV的抗体，并测定血清C反应蛋白（CRP）水平。CRP水平>0.8mg/dl定义为CRP水平升高。
Cp IgG、Hp IgG或Hp IgA抗体的患病率与CAD相关（P = 0.017，P < 0.001，P = 0.009）。在调整年龄、性别、吸烟、高血压、高脂血症和糖尿病后，这种关联仍然存在。与无CAD的患者相比，CAD患者的平均CRP值显著更高（P < 0.001）。多因素分析显示具有统计学意义（P = 0.03）。发现CRP水平升高是CAD的一个重要参数（P = 0.032）。Cp IgG抗体、Hp IgG和CMV IgG抗体的患病率均与CRP水平升高无关（P = 0.391，P = 0.253，P = 0.724）。血清碱性CRP水平升高的比例在三种病原体IgG抗体阳性组为32.1%，而在≤两种病原体IgG抗体阳性组为14.9%。但两组之间无显著差异（P = 0.078）。
两种慢性感染，即Cp和Hp，可能增加CAD的风险。CMV感染与CAD无关。C反应蛋白是CAD的一个独立参数，但CAD中全身炎症的增加似乎与上述感染无关。
