冠状动脉扩张症与肺炎衣原体幽门螺杆菌感染及炎性标志物的相关性研究

Study on the association between coronary ectasia and chlamydia pneumoniae,Helicobacter pylori,and inflammatory markers

目的探索血清中肺炎衣原体、幽门螺杆菌抗体阳性及炎性标志物与冠状动脉扩张症之间的关联性。方法在2005年7月至2006年5月济宁市第一人民医院经冠状动脉造影确诊的缺血性心脏病患者87例,分为血管扩张但不伴动脉粥样硬化者31例为冠状动脉扩张组,无冠状动脉扩张者56例作为对照组。用ELISA法检测血清中肺炎衣原体IgM、IgG,幽门螺杆菌IgA、IgG,白介素-6(IL-6),用微粒增强免疫比浊法测定超敏C-反应蛋白(hsCRP)。结果冠状动脉扩张组30例血清肺炎衣原体IgG抗体阳性,占冠状动脉扩张组总例数的97%;对照组阳性者40例,占71%(P<0.01)。冠状动脉扩张组25例肺炎衣原体IgM阳性,占81%;对照组26例阳性,占46%(P<0.01)。冠状动脉扩张组12例幽门螺杆菌IgA阳性,占39%;对照组27例阳性,占48%(P=0.503)。与对照组相比,冠状动脉扩张组血清中hsCRP升高[(5.639±3.530)mg/L对(4.390±3.560)mg/L,P=0.032]。结论肺炎衣原体感染与冠状动脉扩张症之间存在相关性,且伴有hsCRP的升高,提示在冠状动脉扩张症的发病机制中,可能有感染因素参与。

To investigate the association of C, pneumoniae,H, pylori seropositivity and inflammatory markers with coronary ectasia, Methods Of the 430 patients undergoing coronary angiography for suspected ischemic heart dis-ease,87 patients were recruited, Of these,56 had normal vessels and 31 had ectatic vessels without atherosclerosis, Sero- positivities for all sera samples were tested for H. pylori IgG and IgA and for C. pneumoniae IgG and IgM by the ELISA method, Sermu IL-6 concentrations were deteeted quantitatively by the ELISA method, C-reactive protein（hsCRP） levels were detected using particle-enhanced immunonephelometry. Results Thirty ectatic patients（97% ）were positive for C. pneumoniae IgG, as were 40 controls （ 71%） （ p=0.004）. Twenty-five ectatic patients （ 81% ） were positive for C, pneu-moniae IgM, as were 26 controls （46%） （ P=0.003）, Twelve ectatic patients （ 39% ） were positive for H, pylori IgA, as were 27 controls（48%） （ P=0.503）, High-sensitive CRP levels were significantly higher in ectatic patients[（5.639±3.530） mg/Li than in controls [ （4.390±3.560） mg/L ] （ P=0.032）. Conclusion C, pneumoniae infection is related to ectasia, with raised CRP levels. It suggests that in the pathogenesis of coronary ectasia,infection may be an independent risk factor.