感染病原体总负荷对冠心病危险及血清C-反应蛋白的影响

Effects of Total Pathogen Burden on Coronary Heart Disease Risk and the Serum Levels of C-reactive Protein

目的 :探讨感染病原体总负荷、血清C 反应蛋白 (CRP)与冠心病的关系。 方法 :冠心病组 10 2例 ,对照组 62例 ,检测血清抗肺炎衣原体、抗巨细胞病毒、抗腺病毒、抗单纯疱疹病毒 1型、抗幽门螺旋杆菌 5种IgG型抗体以及CRP水平。根据抗体阳性数分为少于或等于 (≤ ) 2个抗体阳性患者、 3～ 4个抗体阳性患者、 5个抗体阳性患者 ,分析抗体阳性率与冠心病的关系、感染病原体总负荷、CRP水平与冠心病的关系。 结果 :抗肺炎衣原体、抗巨细胞病毒、抗腺病毒、抗单纯疱疹病毒 1型、抗幽门螺旋杆菌等 5种IgG型抗体的阳性率分别是 79 88% (13 1/164 )、 71 95 % (118/164 )、 66 46% (10 9/164 )、 83 5 4% (13 7/164 )、 43 90 % (72 /164 )。接近 80 %的患者有 3种或 3种以上抗体阳性。用危险因素调整后的以上 5种病原体对冠心病危险作用大小的危险比及其 95 %可信限分别是 4 4(1 8～ 10 6)、 11 9(5 0～ 2 8 6)、 2 7(1 3～ 5 5 )、 5 5 (2 0～ 14 7)、 0 1(0 0 4～ 0 2 3 ) ,相互间均有显著性差异 (P <0 0 1)。≤ 2个抗体阳性患者、 3～ 4个抗体阳性患者、 5个抗体阳性患者其冠心病百分率分别是 2 5 0、60 7、 10 0 0 (P <0 0 5 )。 3～ 4个抗体阳性患者与≤ 2个抗体阳性患者比较 ,血?

Objective: To investigate the effects of total pathogen burden on coronary heart disease(CHD)risk and the serum levels of C reactive protein(CRP) Methods: In 164 individuals,including 102 CHD patients and 62 controls,IgG antibodies to chlamydia pneumoniae,cytomegalovirus,adenovirus,herpes simplex virus type 1 and helicobacter pylori,and the serum levels of CRP were measured Analyses of effects of total pathogen burden on CHD risk and the serum levels of CRP were performed Results: The prevalence of IgG antibodies to the pathogens in the 164 patients were as follows: 131 for chlamydia pneumoniae(79 88%),118 for cytomegalovirus(71 95%),109 for adenovirus(66 46%),137 for herpes simplex virus type 1(83 54%)and 72 for helicobacter pylori(43 90%).About 80% of the subjects were exposed to more than 3 of the 5 pathogens tested.Association of the prevalence of CHD with seropositivities with chlamydia pneumoniae,cytomegalovirus,adenovirus,herpes simplex virus type 1 and helicobacter pylori were significant after multivariate analysis and adjustment for traditional CHD risk factors.The OR and 95% CI were 4 4(1 8 10 6),11 9(5 0 28 6),2 7(1 3 5 5),5 5(2 0 14 7) and 0 1(0 04 0 23),respectively.And the percentages of CHD for groups with pathogen burden≤2,3 or 4,and 5 were 25 0,60 7,and 100 0, respectively.The seropositivities were associated with an increased prevalence of CHD(p<0 05).The serum levels of CRP were (2 32±1 23) mg/L,(4 71±2 48) mg/L,(5 62±2 93) mg/L in patients exposed to≤2,3 4 and 5 pathogens,respectively(p<0 05) Conclusion: Increased pathogen burden is associated with elevated serum levels of CRP.The greater the pathogen burden,the more significant the inflammatory reaction,and so the higher risk the CHD is