巨细胞病毒感染与冠心病急性心肌梗死的相关性研究

Relationship between cytomegalovirus infection and acute myocardial infarction

目的探讨巨细胞病毒(CMV)感染与急性心肌梗死(AMI)的关系。方法分别采用酶联免疫法和PCR技术测定51例AMI患者(AMI组)、42例陈旧性心肌梗死患者(陈旧性心肌梗死组)及冠脉造影正常的31例正常对照者(正常对照组)、33例非冠心病患者(非冠心病组)血浆CMV抗体水平及DNA,并检测各组的纤维蛋白原(Fg)、6-酮前列环素(6-Keto-PGF1α)、血栓素B2(TXB2)和P选择素(GMP140)。结果AMI组(治疗前)IgG水平、IgM阳性率及水平显著高于其余组(均P<0.01),DNA检测结果相一致。校正危险因素前、后,IgG阳性与AMI均有相关性(OR3.262,P=0.021;OR3.047,P=0.030)。AMI组IgG(+)与IgG(-)患者比较,Fg、TXB2、GMP140显著升高,6-Keto-PGF1α显著降低(P<0.01或P<0.05);IgG与Fg、TXB2、GMP140呈正相关,与6-Keto-PGF1α呈负相关。结论急性或激活性CMV感染与AMI的发生有关,可能是后者的促发因素。CMV感染可能通过触发或加重冠脉内炎症反应,促使血栓形成,参与动脉粥样硬化、AMI的病理过程。

Objective To investigate the relationship between cytomegalovirus （CMV） infection and acute myocardial infarction （AMI）. Methods The levels of serum anti-CMV antibody, DNA, fibrinogen （ Fg）, 6-ketoprostaglandin F1 alpha （ 6-Keto-PGF1α ）, thromboxane B2 （ TXB2 ） and P-selectin （ GMP140 ） were measured by enzyme-linked immunosorbent assay and PCR in AMI group （ n = 51 ） , old myocardial infarction （OMI） group （ n = 42 patients） ,normal control group （ n = 31 ） and non-coronary heart disease group （ n = 33 ）. Resuits Before treated, the prevalences and levels of CMV-IgG, CMV-IgM in AMI group were significandy higher than those in other groups （ P 〈 0. 01 ）. Correcting of the major cardiovascular risk factors before and after, the prevalence of CMV-IgG was associated with AMI （ OR = 3. 262, 3. 047 ）. IgG-positive patients had significantly higher levels of Fg, TXB2 and GMP140 and lower level of 6-Keto-PGF1α than IgG-negative patients in AMI group （P 〈0. 01, P 〈0. 05）. The level of CMV-IgG was positive correlation with the levels of Fg, TXB2 and GMP140 and negative eorrelation with the level of 6-Keto-PGF1α. Conclusions There is a significant correlation between acute or active CMV infection and AMI. By inducing or accelerating inflammation and thrombosis in coronary artery, CMV infection involves in the pathogenesis of atherosclerosis and AMI.