| 蔡小婕,蔡华波,鲁端.感染和炎症反应与冠心病的相关性研究[J].Chinese journal of Epidemiology,2003,24(6):503-507 |
| 感染和炎症反应与冠心病的相关性研究 |
| Study on the correlation of between infection, inflammation and coronary artery disease |
| Received:August 13, 2002 |
| DOI： |
| KeyWord: 冠状动脉心脏病 肺炎衣原体 幽门螺杆菌 巨细胞病毒 C反应蛋白 |
| English Key Word: Coronary artery disease Chlamydia pneumoniae Helicobacter pylori Cytomegalovirus C-reactive protein |
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| Abstract: |
| 目的探讨肺炎衣原体(Cp)、幽门螺杆菌(Hp)和巨细胞病毒(CMV)感染与全身炎症反应和冠心病的关系。方法将疑有冠心病行冠脉造影检查者根据造影结果分为冠心病组(45例)和对照组(33例)。测定血清学Cp、Hp和CMV抗体及C反应蛋白(CRP)水平。结果(1)CpIgG、HpIgG和IgA阳性率均与冠心病相关(P=0.017、P<0.001、P=0.009)。去除冠心病传统危险因子影响后,仍保持相关性;(2)冠心病组血清CRP较对照组明显升高(P<0.001),经多因素分析后仍有统计学意义(P=0.03);(3)CpIgG、HpIgG和CMVIgG阳性率与高基础CRP水平无关。三种病原体IgG阳性组和两种或两种以下病原体IgG阳性组高CRP比率分别为32.1%和14.9%,但经统计学分析无意义(P=0.078)。结论Cp和Hp慢性感染与冠心病相关,而CMV感染与冠心病无关。尚缺乏证据证明冠心病患者全身炎症反应的增强与Cp和Hp等感染之间的相关性。 |
| English Abstract: |
| Objective 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 inflammatiom and coronary artery disease (CAD).Methods Fourty-five patients with at least one coronary artery stenosis 50% and 33 control subjects with negative coronary angiography were recuited 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.Results 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 ≤2 pathogens it was 14.9%. But with no significante difference between the two (P=0.078).Conclusions 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. |
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