急性心肌梗死患者肺炎衣原体感染对其血液流变学指标的临床影响

Clinical significance of Chlamydia pneumoniae infection on hemorheology indexes of patients with acute myocardial infarction

目的分析急性心肌梗死(AMI)患者出现肺炎衣原体感染对其血液流变学和急性心肌梗死病情的影响,为科学诊治急性心肌梗死作出贡献。方法选取2013年12月-2015年1月医院急性心肌梗死并发肺炎衣原体感染患者65例为感染组,选取同期未合并感染性疾病的急性心肌梗死患者60例为未感染组,同时选取同期体检的60名健康成年人为对照组,比较3组受试者临床指标。结果感染组患者血清C-反应蛋白、可溶性血管细胞黏附因子(sVCAM-1)、肌酸激酶同工酶(CK-MB)、血浆黏度、红细胞指数、全血黏度和血细胞比容均显著高于其他两组(P<0.05);未感染组血清CRP、ET-1、sVCAM-1、CK、CK-MB、CTnⅠ显著高于对照组(P<0.05);logistic分析显示IgA抗体阳性和IgG抗体阳性为AMI独立危险因素(P<0.05)。结论肺炎衣原体感染能够对急性心肌梗死患者血液流变学、血脂等指标产生不良影响,是急性心肌梗死疾病进展的危险因素之一。

OBJECTIVE To analyze the effect of Chlamydia pneumoniae infection on hemorheology indexes of pa- tients with acute myocardial infarction, so as to contribute to the scientific diagnosis and treatment of acute myo- cardial infarction. METHODS A total of 65 patients with acute myocardial infarction complicated with C. pneu- moniae infection were retrospectively selected as infection group, 60 patients with acute myocardial infarction with- out infectious disease were selected as uninfected group, and 60 healthy adults for physical examination were se- lected as control group. The clinical indexes of the three groups were compared. RESULTS The serum levels of CRP, sVCAM-1, CK-MB, plasma viscosity, erythrocyte index, whole blood viscosity and hematocrit of infected group were significantly higher than those of the other two groups （P〈0.05）. The levels of serum CRP, ET-1, SVCAM-1, CK, CK-MB and CTnI in uninfected group were significantly higher than those in control group （P〈 0.05）. Logistic analysis showed that IgA antibody positive and IgG antibody positive were independent risk fac- tors of AMI （P〈0. 05）. CONCLUSION Infection of C. pneumoniae can cause adverse effects on hemorheology, blood lipid and other indexes in patients with acute myocardial infarction, which is one of the risk factors for the progression of acute myocardial infarction.