Gibbs R G, Carey N, Davies A H
Department of Surgery, Imperial College School of Medicine, Charing Cross Hospital, London, UK.
Br J Surg. 1998 Sep;85(9):1191-7. doi: 10.1046/j.1365-2168.1998.00861.x.
There is an increasing body of evidence linking the human pathogen Chlamydia pneumoniae with atherosclerosis.
A Medline-based review of the literature was carried out.
Seroepidemiological studies have revealed the possibility that evidence of infection with C. pneumoniae and atherosclerotic disease are related. Studies on human tissue have demonstrated that evidence of the organism can be found in human atherosclerotic tissue by both direct and indirect methods significantly more often than in control vascular tissue. Using animal models it is possible to show that C. pneumoniae can be disseminated haematogenously following pulmonary infection and that it shows a tropism for atherosclerotic tissue. In vitro work has demonstrated that the organism is capable of infecting, surviving and multiplying in cells of the human vascular wall, and that it can provoke a cell-mediated cytokine response which has implications both locally and systemically. Two clinical trials of macrolide antibiotics have demonstrated that they confer increased cardiovascular protection in patients following myocardial infarction. Adequately powered trials are needed to establish the therapeutic role of antibiotics in peripheral arterial disease.
越来越多的证据表明人类病原体肺炎衣原体与动脉粥样硬化有关。
基于医学在线数据库（Medline）对文献进行综述。
血清流行病学研究揭示了肺炎衣原体感染证据与动脉粥样硬化疾病相关的可能性。对人体组织的研究表明，通过直接和间接方法在人类动脉粥样硬化组织中发现该病原体证据的频率明显高于对照血管组织。利用动物模型可以证明，肺炎衣原体在肺部感染后可通过血液传播，并且它对动脉粥样硬化组织具有嗜性。体外研究表明，该病原体能够在人体血管壁细胞中感染、存活和繁殖，并且能够引发细胞介导的细胞因子反应，这在局部和全身都有影响。两项大环内酯类抗生素的临床试验表明，它们能为心肌梗死后的患者提供更强的心血管保护作用。需要进行足够规模的试验来确定抗生素在周围动脉疾病中的治疗作用。
