Zeman K
I. interní kardio-angiologická klinika Lékarské fakulty MU a FN u sv. Anny, Brno.
Vnitr Lek. 2006 Sep;52(9):823-6.
Atherosclerosis is guided by chronicle inflammation process. In the last decades of the 20th century, studies considering infection another possible risk factor of atherosclerosis development were written. Helicobacter pylori, Porphyromas gingivalis, some viruses but most frequently Chlamydia pneumonie are infection agens mentioned in these studies. Some of them emphasize also combined infections caused by more pathogenic factors having influence on vascular inflammation. Serological, epidemiological, histological and imunological studies show the pathogenic influence of acute or chronic infections. Many studies selected makrolid antibiotics as treatment in patients with ischaemic heart disease. However, existing experience with antibiotics did not bring clear results. These studies have mentioned the fact antibiotics have not been indicated as treatment in patients with acute or chronic vascular system infliction by atherosclerosis. Since the experimental and clinical research of influence of inflammations on the development of atherosclerosis moved forward a lot, no exact evidence of this complicated pathogenic mechanism was given. It will obviously take some time to confirm whether the relation between infections and artherosclerosis is causal, i.e. initiating the pathogenic process, accelerating it or keeping it alive.
动脉粥样硬化由慢性炎症过程主导。在20世纪的最后几十年里，有研究表明感染是动脉粥样硬化发展的另一个可能风险因素。幽门螺杆菌、牙龈卟啉单胞菌、一些病毒，但最常见的是肺炎衣原体是这些研究中提到的感染源。其中一些研究还强调了由更多致病因素引起的联合感染对血管炎症的影响。血清学、流行病学、组织学和免疫学研究表明了急性或慢性感染的致病影响。许多研究选择大环内酯类抗生素作为缺血性心脏病患者的治疗药物。然而，现有的抗生素使用经验并未带来明确的结果。这些研究提到，抗生素并未被推荐用于治疗急性或慢性动脉粥样硬化引起的血管系统损伤患者。由于炎症对动脉粥样硬化发展影响的实验和临床研究取得了很大进展，但尚未给出这种复杂致病机制的确切证据。显然，要证实感染与动脉粥样硬化之间的关系是否具有因果性，即启动致病过程、加速该过程或使其持续存在，还需要一些时间。
