肺炎衣原体感染与急性心肌梗死、超敏C反应蛋白、细胞间黏附分子-1、白细胞介素-6的相关性研究

Relation between Chlamydia pneumoniae infection and acute myocardial infarction,hypersensitive C-reactive protein,intercellular adhesion molecule-1 and interleukin-6

目的探讨肺炎衣原体(Cpn)感染与冠心病心肌梗死及其有关炎症介质的关系。方法分别采用酶联免疫吸附试验(ELISA)法和聚合酶链反应(PCR)测定51例急性心肌梗死、42例陈旧性心肌梗死患者及冠脉造影正常的31例正常对照者、33例非冠心病患者血Cpn抗体水平及DNA,同时检测各组的超敏C反应蛋白(hsCRP)、可溶性细胞间黏附分子(sICAM)-1、白细胞介素(IL)-6的变化。结果急性心肌梗死组Cpn IgG,Cpn IgM阳性率及水平高于正常对照组、非冠心病组,Cpn DNA检测结果与之一致。校正冠心病危险因素前、后,Cpn IgG阳性与急性心肌梗死均有相关性(分别OR=3.653,P=0.025;OR=3.174,P=0.033)。急性心肌梗死组治疗前分别与其余组比较,hsCRP,sICAM-1I、L-6均显著升高(均P<0.01);陈旧性心肌梗死组分别与非冠心病组、正常对照组比较,sICAM-1,IL-6显著升高(均P<0.01),而hsCRP升高不显著。心肌梗死各组中Cpn(+)组与同组Cpn(-)组比较,hsCRP,sICAM-1,IL-6均显著升高(P<0.01或P<0.05);IgG与hsCRP,sICAM-1,IL-6呈正相关。结论Cpn感染与急性心肌梗死存在明显相关性,与hsCRP,sICAM-1,IL-6也存在相关性。

Objective To investigate the correlations between Chlamydia pneurnoniae （Cpn） infection and acute myocardial infarction （AMI） and related inflammation substances. Methods Cpn antibody level and DNA of 51 patients with AMI （AMI group）, 42 patients with old myocardial infarction （OMI group）, 31 normal bontrols （NC group） and 33 patients without coronary artery disease were measured by ELISA and PCR methods. The levels of hypersensitive Creactive protein （hsCRP）, soluble intercellular adhesion molecule-1 （sICAM-1） and interleukin-6 （IL-6） were also determined in four groups. Results The positive rates and levels of Cpn IgG and Cpn Ig M were higher than that in NC and non-coronary artery disease group, Cpn DNA detection results were identical with the above results. Before and after the adjustment of cardiovascular risk factors, Cpn IgG were both correlated with AMI （OR= 3. 653, P = 0. 025 ; OR= 3. 147, P =0. 033 respectively）. The levels of hsCRP, sICAM-1 and IL-6 in the AMI group before treatment were all higher than that in the other groups （all P 〈0.01）. sICAM -1 and IL-6 in OMI group were significantly higher than that in non-coronary artery disease group and NC group （ P 〈 0.01）, hsCRP didn＇t increase obviously. In AMI group, those who were Cpn positive had significantly higher level of hsCRP, sICAM-1 and IL-6 than those who were Cpn negative （ P 〈 0.01 or P 〈 0.05） ; The level of IgG was positively associated with the level of hsCRP, sICAM- 1 and IL- 6. Conclusion There is obvious correlation between Cpn infection and AMI and the inflammation substances.