肺炎衣原体与脑梗死的关系研究

Relationship between Chlamydia pneumoniae infection and cerebral infarction

目的探讨肺炎衣原体（Cpn）与脑梗死之间的关系。方法选取自2005年9月至2007年10月珠江医院神经内科收治的脑血栓患者（150例）、腔隙性脑梗死患者（52例）、脑出血伴梗死患者（62例）、高血压合并高血脂患者（52例）以及健康对照者52例，分别应用微量免疫荧光法（Micro-IFA）检测Cpn特异性抗体IgG、IgM和双抗体夹心酶联免疫吸附法（ELISA）检测各组患者血清中白介素-6（IL-6）和可溶性黏附分子1（sICAM-1）的水平。结果五组患者的Cpn感染率差异有统计学意义泸〈O．001），Cpn特异性抗体IgG与脑梗死有关，脑血栓组患者血清IL-6与sICAM-1水平呈明显正相关（r=0．356，P=0．000），CpnIgG滴度与IL-6水平呈正相关（r=0．204，P=0．022），但与sICAM-1无明显相关性。结论Cpn感染可能通过影响IL-6、sICAM-1水平作用于血管内膜，促进白细胞内皮黏附参与脑梗死的病理过程。

Objective To investigate the relationship between Chlamydia pneumoniae （Cpn） infection and cerebral infarction. Methods This investigation was conducted among 150 patients with cerebral thrombosis, 52 with lacunar infarction, and 62 with intracerebral hemorrhage with concurrent cerebral infarction who were treated in our department between September, 2005 and October, 2007. Another 52 hypertensive patients with hyperlipidemia and 52 healthy volunteers were also included as the control groups. Microimmunofluorescence assay was used to detect Cpn IgG and IgM in all the subjects, and their serum levels of interleukin-6 （IL-6） and soluble intercellular adhesion molecule-I （sICAM-1） were determined using sandwich enzyme-linked immunosorbent assay （ELISA）. Results The rates of Cpn infection differed significantly between the 5 groups （P〈0.001）. The specific antibody IgG of Cpn was found to be associated with cerebral infarction, and a significant correlation was found between serum IL-6 and slCAM-1 levels. The titer ofCpn IgG was positively correlated to serum IL-6 levels but not to sICAM-1 levels. Conclusion Cpn might participate in the pathological process of cerebral infarction by affecting the serum levels of IL-6 and sICAM-1 to mediate changes in the vascular intima and facilitate white blood cell adhesion to the vascular endothelium.