血清肺炎衣原体感染与急性冠脉综合征的关系研究

Infection of Chlamydia pneumoniae and Acute Coronary Syndrome

目的 为探讨肺炎衣原体感染与急性冠脉综合征的关系。方法 应用间接微量免疫荧光法测定 92例急性冠脉综合征 (病例组 ) ,其中不稳定型心绞痛组 5 0例 ,急性心肌梗死组 4 2例患者 ,72例健康人 (对照组 )血清肺炎衣原体特异性 Ig G、Ig M抗体滴度。结果 对照组、不稳定型心绞痛组及急性心肌梗死组肺炎衣原体总感染率分别为 30 .6 0 %、86 %、88.1% ,其中既往感染率分别为 30 .6 %、6 2 .0 %、71.4 % ,急性感染率分别为 0 %、2 4 .0 %、16 .7% ;总感染率、既往感染率及急性感染率病例组明显增高 (优势比分别为 15 .15、4 .4 7、18.4 8,可信区间分别为 6 .9～ 33.2 9、2 .31～ 8.6 7、2 .4 1～ 14 1.73) ;与对照组比较病例组各亚组血清肺炎衣原体 Ig G抗体平均几何滴度差异有非常显著性 (P<0 .0 1) ,Ig M抗体病例组仅 4例阳性 ,对照组无 1例阳性 ;不稳定型心绞痛患者与急性心肌梗死患者血清肺炎衣原体平均几何滴度及感染阳性率差别均无明显性。结论 研究结果表明急性冠脉综合征组肺炎衣原体感染率及血清肺炎衣原体平均几何滴度均较高 ,肺炎衣原体感染可能是构成冠心病发生的一个危险因子 ,但抗体滴度与病情的进展无明显关系。

OBJECTIVE To study the association between the chronic infection with Chlamydia pneumoniae and acute coronary syndrome(ACS). METHODS Serology of C. pneumoniae -specific IgG and IgM antibodies was measured by microimmunofluorescence test in groups of 72 health control Patients (HC),50 patients with unstable angina pectoris (UAP) and 42 patients with acute myocardial infarction(AMI). RESULTS The total infection rates were 30.60%,86%,and 88.1%,respectively,including the previous infection rates were 30.6%, 62.0%,and 71.4% and the acute infection rates were 0%,24.0%,and 16.7% in groups of control,UAP and AMI. The frequency of total infection,previous infection and acute infection was significantly higher in ACS group than in the controls (Odds ratio 15.15,4.47,18.48,CI6.9-33.29,2.31-8.67,2.41-141.73). Geometric mean IgG titer was significantly higher in patients with ACS compared with the controls. No significant difference was found between both unstable angina pectoris group and acute myocardial infarction group. CONCLUSIONS Chronic C. pneumoniae infection may be a risk factor of ACS. The specific antibodies titer doesn′t contribute to the developing of coronary heart disease.