微量免疫荧光标记法检测冠心病患者血清肺炎衣原体抗体

Determination of specific-antibodies against chlamydia pneumoniae by indirect microimmunofluorescence test

目的 测定冠心病患者的血清肺炎衣原体特异性抗体 ,探讨其临床价值。方法 应用间接微量免疫荧光标记法对 2 0 5例体检健康人群和 170例住院确诊的冠心病患者进行肺炎衣原体特异性抗体 Ig G、Ig M的检测。结果 体检健康人群 Ig G总阳性率 2 1.5 % ;均阴性 ;冠心病患者 Ig G总阳性率为 91.2 % ,Ig M阳性率为 5 % ,其中无症状型冠心病组、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 96 .2 %、86 %、88.1% ,既往感染率分别为 76 .9%、6 2 .0 %、71.4 % ,急性感染率分别为 19.2 %、2 4 .0 %、16 .7%。总感染率、既往感染率及急性感染率冠心病组较健康人群组明显增高 (优势比分别为 4 .14、2 .88、19.2 4 ,95 %的可信区间分别为 3.18～ 5 .39、2 .2 1～ 3.74、2 .79～ 132 .6 7)。结论 微量免疫荧光标记法系目前冠心病患者血清检测肺炎衣原体特异性抗体 ,从而确定肺炎衣原体感染的一个敏感度高、特异性强 ,简单易行的方法之一。

Objective Infection with chlamydia pneumoniae has been postulated to play a pathogenic role in atherosclerosis and coronary heart diseases.To investigate the relation between chlamydia pneumoniae infection and serum levels of species specific IgG and IgM.Methods Species specific serum antibodies to chlamydia pneumoniae were measured using indirect microimmunofluorescence test in 205 normal healthing subjects(control) and 170 patients with coronary heart diseases(CHD),including 78 cases of latent coronary heart diseases(LCHD),50 of unstable angina(UAP) and 42 of acute myocardial infarction(AMI).2ml of venous blood was collected in sterile tubes .Serum was frozen in -80℃ refrigeration.Results The total IgG positive rates were 21.5% and 91.2% in control and CHD groups. There is no IgM positive in control but there were 5% in CHD group. The total infection positive rates ,the previous infection rates and the acute infection rates were significantly higher in CHD group than in the Control group.Odds Ratio for the development of CHD were 4.14,2.88,19.24,(95% CI 3.18 to 5.39,2.21to 3.74,2.79 to132.67). Conclusion Chlamydia pneumoniae infection rate significantly increase in patients with LCHD,UAP and AMI which may play a important role.The Determination of specific-antibodies against chlamydia pneumoniae by indirect microimmunofluorescence test woule be helpful to the study of this CHD infection.