慢性感染及炎症反应与冠状动脉病变程度的相关性研究

Correlation between chronic infection and inflammatory reaction and degree of coronary artery disease

目的探讨冠状动脉病变程度与微生物慢性感染及炎症反应的关系。方法选取2015年9月-2016年9月冠心病患者150例为观察组,按冠状动脉病变支数进行分组,以同期50例健康体检者为对照组,ELISA测定患者血清肺炎衣原体抗体(Cpn-IgG,Cpn-IgA)、幽门螺杆菌抗体(HP-IgG)、人类巨细胞病毒抗体(HCMV-IgG)水平,生化仪测定C-反应蛋白(CRP)及白细胞(WBC)计数,比较Cpn-IgG、Cpn-IgA、HP-IgG、HCMV-IgG、CRP、WBC与不同冠状动脉病变程度的关系。结果观察组中,三支病变组、双支病变组及单支病变组与对照组比较,Cpn-IgG、HP-IgG、HCMV-IgG阳性率均显著升高,差异有统计学意义(χ2=9.2384,14.1228,7.6054,P<0.05),观察组不同支数病变组患者Cpn-IgG、HP-IgG、HCMV-IgG均高于对照组;观察组中,随着病变程度的加重,Cpn-IgG、HP-IgG、HCMV-IgG升高,差异有统计学意义(P<0.05),观察组中3种不同冠脉病变程度的Cpn慢性感染率分别为:单支病变组为18.00%、双支病变组为33.33%、三支病变组为71.42%;观察组Cpn慢性感染率为40.67%,显著高于对照组,差异有统计学意义(P<0.01);观察组中,不同支数病变组患者Cpn-IgA的截断指数值均高于对照组;观察组中,双支病变组、三支病变组与单支病变组患者相比,血清CRP及WBC水平均显著升高,差异有统计学意义(P<0.05);不同冠状动脉病变程度的患者血清Cpn-IgA与CRP及WBC之间呈正相关(P<0.01);CRP与WBC亦呈正相关(P<0.01)。结论血清Cpn-IgA水平与冠状动脉病变程度有一定的关系,在冠状动脉病变过程中有炎症反应的参与。

OBJECTIVE To explore the relationship among the degree of coronary artery disease,microbial chronic infection and inflammatory reaction.METHODS A total of 150 patients with coronary heart disease who were treated in hospitals from Sep 2015 to Sep 2016 were chosen as the observation group and were grouped according to the number of coronary arteries of lesions,meanwhile,50 healthy people who received physical examination were set as the control group.The levels of serum Chlamydia pneumoniae antibodies（Cpn-IgG,Cpn-IgA）,Helicobacter pylori antibody（HP-IgG）,and human cytomegalovirus antibody（HCMV-IgG）were determined by means of ELISA;the C-reactive protein（CRP）and white blood cell（WBC）counts were detected by using biochemical system.The relationship between the Cpn-IgG,Cpn-IgA,HP-IgG,HCMV-IgG,CRP,and WBC and the degree of coronary artery lesions was observed.RESULTSIn the observation group,the positive rates of Cpn-IgG,HP-IgG,and HCMV-IgG were significantly higher in the triple-vessel lesion group,double-vessel lesion group,and single vessel lesion group than in the control group（χ2=9.2384,14.1228,7.6054,P〈0.05）.The levels of Cpn-IgG,HP-IgG,and HCMV-IgG of the patients with different numbers of coronary artery of lesions in the observation group were significently higher than those of the patients in the control group.The levels of Cpn-IgG,HP-IgG,and HCMV-IgG of the observation group were significently elevated with the aggravation of degree of lesion（P〈0.05）.In the observation group,the incidence rate of chronic Cpn infection was 18.00%in the single vessel lesion group,33.33%in the double-vessel lesion group,71.42%in the triple-vessel lesion group;the incidence rate of chronic Cpn infection of the observation group was 40.67%,significantly higher than 0of the control group（P〈0.01）.The truncated exponential value of Cpn-IgA of the patients with different numbers of coronary arteries of lesions in the observation group was higher than that of the patients in the control group.In the observation group,the levels of serum CRP and WBC of the patients with triple-vessel lesion and the patients with double-lesion were significantly higher than those of the patients with single vessel lesion（P〈0.05）.The serum Cpn-IgA of the patients with different degree of coronary artery lesions was positively correlated with the CRP and WBC（P〈0.01）;the CRP was also positively correlated with the WBC（P〈0.01）.CONCLUSIONThe serum Cpn-IgA level is,to some extent,associated with the degree of coronary artery lesion,and the inflammatory reactions may involve during the process of coronary artery lesion.