肺炎衣原体感染与冠心病急性心肌梗死血液流变特性关系的研究

Hemorheological correlation between chlamydia pneumoniae infection and acute myocardial infarction

目的 探讨肺炎衣原体(Cpn)感染与冠心病心肌梗死的关系。方法 测定5 1例急性心肌梗死(AMI)和42例陈旧性心肌梗死(OMI)患者及3 1例冠脉造影正常者(NC)血Cpn抗体水平及DNA ,同时观测纤维蛋白原(Fg)和血液流变学指标。结果 AMI组CpnIgG、CpnIgM阳性率及水平高于NC组(P <0 0 5 ) ,CpnDNA检测结果与之吻合。校正冠心病危险因素前、后,CpnIgG阳性与AMI均有关系(OR =3 65 3 ,P =0 0 2 5 ;OR =3 .174,P =0 .0 3 3 )。AMI组中Cpn(+ )组IgG、Fg、血浆粘度(ηP)、高/低切(15 0s-1/ 10s-1)全血粘度(ηb)、红细胞聚集指数(EAI)高于,而红细胞变形指数(TK)低于Cpn( )组(P均<0 0 5 ) ,且IgG与ηb(10s-1)、ηb(15 0s-1)、ηp、EAI呈正相关,与TK呈负相关,调整冠心病的危险因素前、后,IgG与Fg均呈正相关。结论 Cpn感染与AMI之间存在明显的关系,与Fg、血液流变特性指标也存在相关性。

Objective To investigate the correlations between chlamydia pneumoniae (Cpn) infection and acute myocardial infarction (AMI). Methods Specific Cpn antibodies and the DNA were measured in 51 patients with AMI (AMI group), 42 patients with old myocardial infarction (OMI group) and 31 normal controls (NC group) who had no angiographic evidence of coronary artery diseases. Moreover, the changes of and relationships between fibrinogen (Fg), hemorheological parameters and Cpn infection were determined in the three groups. Results The positive rates and levels of Cpn IgG and Cpn IgM in the AMI group were higher than those in the NC group (P<0.05), which was consistent with the results of Cpn DNA detection. Adjustment for the major cardiovascular risk factors did not attenuate this correlation (OR=3.174). Those who were Cpn positive in the AMI group had significantly higher levels of IgG, Fg, plasma viscosity (η p), whole blood viscosity (η b) at 150 s -1 /10 s -1 and erythrocyte aggregation index (EAI), and a significantly lower levels of erythrocyte deformation index (TK) than those who were Cpn negative in the same group. Correlation analysis revealed that the average concentration of IgG antibody to Cpn was positively associated with the levels of Fg, η p, η b (10 s -1 ) and η b (150 s -1 ) , but negatively associated with the level of TK in the Cpn positive patients of the AMI group. Conclusion There is a significant correlation between Cpn infection and AMI. Cpn infection is associated with Fg and hemorheological parameters.