肺炎衣原体感染增加血脂紊乱者患冠心病的危险性

Chlamydia pneumoniae infection increases the risk of coronary artery disease in the patients with dyslipidemia

目的 探讨肺炎衣原体 (CP)感染对血脂紊乱者患冠心病的影响。方法 选择 1998年 6月至 2 0 0 1年 5月在阜外医院进行冠状动脉造影或诊断为急性心肌梗死的患者 1719例 ,其中血脂紊乱5 2 3例 ,非血脂紊乱 1196例 ,应用间接酶联免疫吸附实验检测患者血清中的特异性CPIgG抗体。多元Logistic回归方法分析冠心病的危险因素。结果 调整年龄、性别、吸烟、高血压和糖尿病的影响后 ,在血脂紊乱组 ,CP感染对冠心病危险度比值比 (OR)为 2 5 ,95 %可信区间为 1 4～ 4 6 (P =0 0 0 2 ) ,显著高于非血脂紊乱组OR为 0 96 7(0 7～ 1 4 ,P =0 85 1)。CP感染和吸烟同是男性血脂紊乱者冠心病的独立危险因素 ,调整OR分别为 2 1(1 1～ 4 1)和 3 3(1 9～ 5 9) ;但在女性血脂紊乱组 ,只有CP感染能显著增加冠心病易感性 ,调整OR值为 4 4 (1 4～ 14 6 ,P =0 0 16 )。结论 CP感染能增加血脂紊乱者患冠心病的危险性 。

Objective To investigates the role of chlamydia pneumoniae (CP) infection in the development of coronary artery disease (CAD) in the patients with dyslipidemia, and to examine the gender related differences in this role Methods 523 inpatients with dyslipidemia and 1196 inpatients without dyslipidemia tested for specific CP IgG by enzyme-linked immunoassay Multivariate analyses were performed in the patients with and without dyslipidemia, and in the subgroups of male and female dyslipidemic patients to get the adjusted odds ratio ( OR ) (95% confidence intervals) of CAD for a given risk factor Results After adjusting for age over 55 years, male sex, smoking, hypertension and diabetes, the OR of CAD associated with CP infection was 2 5 (1 4 to 4 6, P = 0 002) in the patients with dyslipidemia, and was 0 967(0 7 - 1 4, P = 0 851) in those without dyslipidemia In comparison with the male patients with dyslipidemia, the adjusted OR of CAD was 2 1 (1 1 to 4 1) for CP infection and 3 3(1 9-5 9)for smoking; only CP infection was significantly contributed to CAD in female dylipidemic patients, with an adjusted OR of 4 4 (1 4 to 14 6) Conclusion CP infection increases the risk of CAD only in patients with dyslipidemia, and this increase was greater in women than in men