肺炎衣原体感染与老年人不稳定性心绞痛相关性的探讨

Exploration of correlation between Chlamydia pneumoniae infection and unstable angina pectoris in old patients

目的 探讨肺炎衣原体 (CP)感染与老年人不稳定性心绞痛 (UAP)的相关性。方法 将 10 0例UAP患者及 6 0例体检健康的老年人分为UAP组和对照组 ,分别进行CP抗体 (IgG)和C 反应蛋白 (CRP)检测 ,比较UAP组和对照组的CP抗体阳性率 ,CRP阳性率及UAP中CP抗体阳性与CP抗体阴性患者的CRP阳性率。并将CP抗体 (IgG)检测阳性的 80例UAP患者 ,随机分为阿奇霉素组和常规治疗组。 2组患者均接受常规治疗。阿奇霉素组在常规治疗基础上加用阿奇霉素 0 .5g ,每日 1次 ,连用 10～ 15d。观察UAP患者终点事件的发生率。结果 (1)血清学检查显示CP抗体阳性率在UAP组为 80 .0 % ,对照组仅为 2 3.3% ;CRP阳性率在UAP组最高 (37.0 % )。 (2 )在UAP患者中CP抗体阳性组CRP阳性率高于CP抗体阴性组 ,分别为 4 0 .0 %和 2 5 .0 %。 (3)在CP抗体阳性的老年UAP患者中 ,阿奇霉素组在 1年内因UAP再次入院的发生率明显低于常规治疗组。结论 CP感染与老年UAP的关系密切 ,对UAP患者给予抗生素干预治疗 ,可防止UAP的恶化并改善其预后。

Objective To explore the correlation between the infection of Chlamydia pneumoniae (CP) and unstable angina pectoris (UAP)in old patients.Methods One hundred UAP patients and 60 healthy old persons were divided into UAP group and control group.The antibody IgG of CP and C-reactive protein(CRP) were investigated in the studied cases.The positive rates of CRP and the antibody of CP were compared between UAP and control groups.In UAP patients,the positive rate of CRP was compared between CP antibody positive and negative groups.Eighty patients with positive CP results were divided into the azithromycin group and the conventional treatment group at random. All patients were given the conventional treament.Patients of the azithromycin group were also given azithromycin 0.5 g qd for 10～15 successive days.The incidences of final events were observed.Results (1) the positive rate of the antibody of CP in UAP group was 80.0% by serological examination. In the healthy control group the positive rate was 23.3%.The positive rate of CRP in UAP group was the highest (37.0%).(2) The positive rate of CRP in CP antibody positive group (40.0%) was higher than that in CP antibody negative group (25.0%).(3) Patients with UAP and positive CP antibody who were given azithromycin had less events of UAP in one year than those of the conventional treatment group.Conclusion The study showed that the infection of CP and UAP in the old patients were closely correlated.The intervention with antibiotics in UAP can prevent the exacerbation of UAP and make prognosis better.