Wimmer M L, Sandmann-Strupp R, Saikku P, Haberl R L
Department of Neurology, Städtisches Krankenhaus München-Harlaching, Germany.
Stroke. 1996 Dec;27(12):2207-10. doi: 10.1161/01.str.27.12.2207.
Recent studies suggest an association of coronary heart disease and carotid atherosclerosis with Chlamydia pneumoniae infection. We investigated the frequency of chlamydial seropositivity and specific circulating immune complexes in patients with recent cerebrovascular disease.
Specific antibodies to C pneumoniae in serum were measured by the microimmunofluorescence test in 58 consecutive patients (aged 18 to 50 years) with ischemic infarction (n = 39) or transient ischemic attacks (n = 19) and in 52 hospital control subjects without vascular disease, matched for sex, age, time, and locality.
Twenty-seven patients (46.6%) and 12 control subjects (23.1%) had raised IgA titers > or = 1:16 (P = .018). IgG titers > or = 1:32 were measured in 74.1% of the patients and 77% of control subjects (P = .623). Specific IgG antibodies in circulating immune complexes, which were isolated by polyethylene glycol precipitation, were elevated > or = 1:8 in 24.1% of the patients and 7.7% of control subjects (P = .047). With the use of a conditional logistic regression model, the odds ratios were 1.70 (95% confidence interval [CI], 1.13 to 2.58) for elevated IgA titers, 1.91 (95% CI, 1.06 to 3.47) for the presence of immune complexes, and 1.96 (95% CI, 1.00 to 3.82) for the presence of both factors. After adjustment for the vascular risk factors hypertension, age, sex, and migraine, the odds ratios were 1.71 (95% CI, 1.08 to 2.70), 2.00 (95% CI, 1.07 to 3.76), and 2.20 (95% CI, 1.09 to 4.41), respectively.
We conclude that chronic infection with C pneumoniae is associated with an increased risk of stroke and transient ischemic events.
近期研究表明冠心病和颈动脉粥样硬化与肺炎衣原体感染有关。我们调查了近期患脑血管疾病患者的衣原体血清阳性率及特异性循环免疫复合物的情况。
采用微量免疫荧光试验检测了58例连续的患者（年龄18至50岁）血清中肺炎衣原体的特异性抗体，其中缺血性梗死患者39例，短暂性脑缺血发作患者19例；并检测了52例无血管疾病的医院对照者，这些对照者在性别、年龄、时间和地点上进行了匹配。
27例患者（46.6%）和12例对照者（23.1%）的IgA滴度升高≥1:16（P = 0.018）。74.1%的患者和77%的对照者检测到IgG滴度≥1:32（P = 0.623）。通过聚乙二醇沉淀分离出的循环免疫复合物中的特异性IgG抗体，24.1%的患者和7.7%的对照者升高≥1:8（P = 0.047）。使用条件逻辑回归模型，IgA滴度升高的比值比为1.70（95%置信区间[CI]为1.13至2.58），免疫复合物存在的比值比为1.91（95%CI为1.06至3.47），两种因素都存在的比值比为1.96（95%CI为1.00至3.82）。在对血管危险因素高血压、年龄、性别和偏头痛进行调整后，比值比分别为1.71（95%CI为1.08至2.70）、2.00（95%CI为1.07至3.76）和2.20（95%CI为1.09至4.41）。
我们得出结论，肺炎衣原体慢性感染与中风和短暂性缺血事件风险增加有关。
