肺炎衣原体感染、炎性反应与脑梗死的临床相关性研究

The clinical study of relationships between inflammation,Chlamydia pneumoniae infection and cerebral infarction

目的探讨肺炎衣原体（CPn）感染、炎性反应标记物超敏C反应蛋白（hs-CRP）及白细胞介素（IL）-6与脑梗死的相互关系。方法采用酶联免疫吸附双抗体夹心法测定50例脑梗死患者（脑梗死组）和48例健康体检者（健康对照组）血清CPn-IgG和IgM、IL-6。用免疫透射比浊法测定hs-CRP，颈动脉超声检查血管内膜增厚情况。结果脑梗死组IL-6、hs-CRP水平明显高于健康对照组（P〈0．01），脑梗死组CPn-IgM（＋）率和CPn-IgG（＋）率均高于健康对照组，差异有统计学意义（P〈0．01）。CPn-IgG（＋）者，颈动脉内膜斑块的发生率、hs-CRP和IL-6的水平均明显高于CPn-IgG（-）者（P〈0．01）。结论CPn慢性感染与脑梗死密切相关。其参与脑梗死的可能机制是CPn感染诱导hs-CRP和IL-6的产生，刺激机体免疫炎性反应，加重动脉粥样硬化，从而促进脑梗死的发生。

Objective To investigate the relationship between infection of Chlamydia pneumoniae （CPn） ,high-sensitive C-reaction protein（hs-CRP） and cerebral infarction. Methods Blood samples were collected from 50 cerebral infarction（CI） patients（ CI group） and 48 cases as healthy controls（ healthy control group）. The serum specific antibodies（IgG, IgM） of CPn and interleukin（IL）-6 were measured by the enzyme-hnked immunosorbent assay. The serum hs-CRP level was analyzed by immunoturbidimetry. Carotid artery was detected by color-Doppler ultrasound. Results The positive rate of IgG and IgM were higher in CI group（P 〈 0.01 ）, and the concentration of IL-6 and hs-CRP were higher（P 〈 0.01 ）. The incidence rate of atheromatous plaque of carotid artery was higher in seropositive than that in seronegative individuals. Conclusion Chronic infection with CPn is significantly associated with CI, which may contribute to the initiation and progression of atherosclerosis by inducing IL-6 and inflammatory acute phase protein hs-CRP.