冠心病患者血液中肺炎衣原体抗体、血管性假性血友病因子和血脂的变化及其临床意义

Relation between chlamydia pneumoniae infection,von Willebrand factor and serum lipids with coronary heart disease

目的研究冠心病(CHD)患者肺炎衣原体(Cpn)感染与血管性假性血友病因子(vWF)、血脂的相互关系,从而探讨CHD可能的发病机制。方法将CHD患者120例分为急性心肌梗死(AMI)组44例、不稳定心绞痛(UAP)组36例、稳定性心绞痛(SAP)组40例,另选取60例正常人作为对照组。所有对象均通过微量免疫荧光法测量Cpn特异性抗体,用酶联吸附法测定vWF,用全自动生化仪测定血脂。结果 AMI组、UAP组Cpn特异性抗体阳性率高于对照组,差异有统计学意义(P<0.05)。Cpn特异性抗体阳性患者vWF及血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平高于Cpn特异性抗体阴性者,高密度脂蛋白胆固醇(HDL-C)水平低于对照组,差异有统计学意义(P<0.05);且血浆vWF及TC、TG、LDL-C水平与Cpn特异性IgG抗体几何平均滴度呈正相关,HDL-C水平与之呈负相关。结论 Cpn致CHD的可能机制为:Cpn感染使体内vWF水平升高,协同血脂异常,激发和加重冠状动脉内炎性反应,促进患者血液黏稠度增加,动脉血栓发生率升高,参与动脉粥样硬化(AS)的发生发展。

Objective To investigare the relation between chlamydia pneumoniae （Cpn） inrection and plasma levels of yon willebrand factor（vWF） and serum lipids in coronary heart disease （CHD）, in order to find out the probable mechanism of CHD. Methods According to the type of disease, 120 cases of CHD patients were divided into acute myocardial infarction （AMI） group （44 cases）, unstable angina pectoris （UAP） group （ 36 cases）, stable angina （SAP） （40 cases ）. 60 normal sub, jects were as control group. All people measured by microimmunofluorescence assayed Cpn antibodies, using enzyme-linked as- sayed vWF,measured by automatic biochemistry assayed lipids. Results The positive rate of Cpn specific antibody in AIM group and UAP group were higher than that in control group （P 〈 O. 05 ）. The levels of vWF total cholesterol （TC）, triglyceride （TG） ,low density lilpoprotein cholesterol （LDL-C）in coronary patients were higher than that in control group （P 〈 0.05 ）and positively correlated to each other. The levels of vWF and TC,TG, LDL-C in seropositive were higher than seronegative individ- uals （ P 〈 0. 05 ） and they were positively correlated to the geometric mean titer（IgG）. The levels of HI）L-C were negatively with it. Conclusion Chronic infection with Cpn is significantly associated with CHD, it may contribute to the initiation and progres- sion of atherosclerosis by inducing the proinflammatory cytokine vWF and cooperate with dyslipidemia, this promoted and in- creased the blood viscosity, the incidence rate of thrombus of artery is ascending.