Cheng J W, Rivera N G
Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY 11201, USA.
Ann Pharmacother. 1998 Dec;32(12):1310-6. doi: 10.1345/aph.18057.
Numerous studies have reported an association of coronary atherosclerosis and restenosis with certain bacterial and viral infections. This article reviews the pathophysiology of atherosclerosis, the role of infectious agents (i.e, cytomegalovirus and Chlamydia pneumoniae) in atherogenesis, and studies supporting the potential beneficial effects of antibiotics or antiviral agents in the management of atherosclerotic disease.
English-language clinical studies, abstracts, and review articles pertaining to infectious agents and coronary atherosclerosis.
Relevant seroepidemiologic and pathologic studies and animal models evaluating the role of cytomegalovirus or C. pneumoniae in coronary atherosclerosis.
Studies evaluating the possible role of cytomegalovirus and C. pneumoniae in the pathogenesis of atherosclerosis, as well as studies examining the use of antimicrobial and antiviral agents for reduction of cardiovascular events, are reviewed and critiqued.
Current data do not allow us to determine whether infection is a cause or a cofactor of atherosclerosis. These uncertainties can be resolved by larger scale seroepidemiologic, pathologic, and interventional studies. Such efforts will contribute to identifying populations that are appropriate for particular surveillance or specific interventions, such as antibiotics or antiviral therapy.
众多研究报告了冠状动脉粥样硬化和再狭窄与某些细菌及病毒感染之间的关联。本文综述了动脉粥样硬化的病理生理学、感染因子（即巨细胞病毒和肺炎衣原体）在动脉粥样硬化形成中的作用，以及支持抗生素或抗病毒药物在动脉粥样硬化疾病管理中潜在有益作用的研究。
与感染因子和冠状动脉粥样硬化相关的英文临床研究、摘要及综述文章。
评估巨细胞病毒或肺炎衣原体在冠状动脉粥样硬化中作用的相关血清流行病学和病理学研究以及动物模型。
对评估巨细胞病毒和肺炎衣原体在动脉粥样硬化发病机制中可能作用的研究，以及考察使用抗菌和抗病毒药物减少心血管事件的研究进行了综述和批判。
目前的数据无法让我们确定感染是动脉粥样硬化的病因还是辅助因素。这些不确定性可通过大规模血清流行病学、病理学和干预性研究来解决。此类研究将有助于确定适合进行特定监测或特定干预（如抗生素或抗病毒治疗）的人群。
