Preparation and analysis of immunocompetence of recombinant fusion protein of the immunodominant region in chlamydial protease-like activity factor from Chlamydophila pneumoniae and its application in serodiagnosis

To clone the gene coding the immunodominant region in the chlamydial protease-like activity factor （CPAF） from Chlaroydophila pneumoniae, to analyze immunoeoropetenee of the expressed protein, and to evaluate its value in serodiagnosis, the CPAF immunodominant region gene was amplified, ligated into a pGEX6p-2 vector, and then the expressed recombinant protein was purified with glutathione Stransferase （GST） agarose gel FF after renaturation, then identified by SDS-PAGE and Western blot. A new indirect ELISA was developed with the purified protein as coating antigen. The immunogenicity of the recombinant protein was evaluated by immunization to New Zealand rabbits, and its immunoreactivity was analyzed by reacting with anti-C, pneumoniae antibody. 300 clinical sera samples were respectively detected by mieroimmunofluorescenee （MIF） as reference method and the indirect ELISA, and the difference between the two methods was analyzed. Cross-reactivity against Chlamydia trachomatis was investigated with the indirect ELISA to detect anti-C, trachomatis positive antisera. The results indicated that a 51.3 kDa recombinant protein was obtained. Western blot assay proved that the recombinant protein could merely specifically react with human anti- C. pneurnoniae antisera. The titers of the specific IgG antibodies in the immunized New Zealand rabbits were above 1 ： 16 000. Anti- C. pneumoniae IgG positive and negative reference sera were detected with the indirect ELISA, and the concordance rate of negative and positive results were both 100% （40/40）. The sensitivity and specificity of the indirect ELISA in comparison with MIF were 93.8% （45/48） and 100% （252/252） separately by detecting 300 clinical sera samples, and the concordance rate between the two methods was 99.0%. No cross reaction against C. trachomatis was found with the indirect ELISA to detect anti-C, trachomatis positive antisera. In conclusion, the prepared recombinant protein of the CPAF immunodominant region shows excellent immunocompetence and can be used to develop a new indirect ELISA as a method to detect anti-C, pneumoniae antibody for diagnosis of C. pneumoniae infection.

Involvement of TLR2 and TLR4,Chlamydophila pneumoniae and Mycoplasma pneumoniae in adventitial inflammation of aortic atherosclerotic aneurysm

Aortic atherosclerotic aneurysm (AAA) is associated with adventitial inflammation where infection is suggested to have a role. Co-infection with Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) was linked with coronary plaque rupture, in association with vessel dilatation and adventitial inflammation. Pathogens are recognized by Toll-like receptors (TLRs) development of the inflammatory process. Objective: Here, we studied whether co-infection by Cp and Mp was involved in the increased inflammation present in AAA and if it could be associated with deficient expression of TLRs. We compared human samples of AAA with non-dilated human aortic atherosclerotic lesions, regarding the amount of Cp and Mp antigens, and expression of TLR2 and TLR4. Methods: Two groups of aorta fragments were analyzed: G1 (n = 13) moderate atherosclerosis and G2 (n = 14) AAA samples, through immunohisto-chemistry and in situ hybridization methods. Results: Mp and Cp antigens in intima/medial layer were greater in G2 than G1, with no difference in adventitia. TLR2 and TLR4 were higher in G2 than G1 adventitia fat. There was a correlation between Mp versus TLR2 and of TLR4 in intima/medial layer and in adventitia of G1, but there was a lack of correlation in G2. In Cp adventitia, the correlation in G1 was high with TLR2 but not with TLR4, and in G2 the correlation was positive for both TLRs. Conclusion: This study favors the concept that symbiotic co-infection by Cp and Mp participates in the pathogenesis of AAA. It also emphasizes that adventitial fat is the initial site for colonization of these bacteria that probably reach the tissue through vasa vasorum. An exacerbated immune reaction is not efficient to control the infection that reaches and proliferates in high levels at the medial and intimal layer, contributing to the development of vessel dilatation.

Seropositivity of Chlamydophila pneumoniae immunoglobulin G antibody of HIV/AIDS patients in Abuja,Nigeria

Objective:To detect IgG antibody to Chlamydophila pneumoniae(CP) in sera of HIV/AIDS patients and provide rationale for inclusion of routine screening for anti-CP antibodies and anti-chlamydial agents in the Nigerian National H1V/AIDS Management Plan.Methods:Serum samples from 34 consenting HIV/AIDS patients attended a Government-approved Antiretroviral Treatment Facility in Abuja were screened by enzyme-linked immunosorbent assay for anti-CP IgG antibody using ImmunoComb? Chlamydia Bivalent IgG Test kit(Orgenics,Israel).Results: Anti-CP IgG antibody was detected in 20(58.8%) of 34 patients tested.The detection rale was higher among the males(8/13:61.5%) than the females(12/21:57.1%).Patients of the age group 16-30 years had the highest(7/10:70%) detection of anti-CP IgG antibody.Conclusions:The result of the present study suggests the presence of anti-CP antibodies in sera of the HIV/AIDS patients,and reinforces the need for routine screening for anti-CP antibodies as a necessary intervention to reduce the burden of Chlamydophila pneumoniae(C.pneumoniae) infections and to reduce HIV-positive morbidity in Nigeria.The outcome of this study also provides justification for the possible inclusion of anti-chlamydial agents in the National HIV/AIDS Management Plan to provide prophylaxis against or treat active C.pneumoniae infections.

Evaluation of Association between <i>Chlamydophila pneumoniae</i>and Atherosclerotic Plaques in Coronary Artery Disease Patients with Abnormal Angiography

The role of Chlamydophila pneumoniae in pathogenesis of atherosclerosis is one of the most important discussions in coronary artery diseases. In this study, the relationship between C. pneumoniae seropositivity and atherosclerotic plaque was evaluated among two groups: one group with significant coronary stenosis and one group with normal coronary angiography. Serum C. pneumonia IgM and IgG were evaluated and compared in case and control groups. The seropositivity rates of IgM and IgG antibodies were not statistically differ between case and control groups, although the incidences of positivity were more in case group. The results of our study did not show a correlation between C. pneumonia infection and atherosclerotic plaque or coronary artery stenosis neither in acute nor in chronic infection. More precise studies are needed to clarify the probable inflammatory cascade that starts with C. pneumonia infection and lead to development of atherosclerotic plaque.

宏基因组二代测序辅助诊断鹦鹉热一例并文献复习

目的:探讨鹦鹉热的临床特征、流行病学特点、诊治及预后。方法:回顾性分析山东省千佛山医院呼吸与危重症医学科收治的1例鹦鹉热衣原体肺炎患者,对其诊治过程进行分析。以“Psittacosis”为检索词检索PubMed数据库,以“鹦鹉热”为检索词检索万方数据库、维普数据库及中国知网,对相关文献进行分析。结果:患者,男性,52岁,因“发热、咳嗽20 d”入院,既往有高血压病史。患者于院外先后经过莫西沙星和头孢哌酮钠舒巴坦钠抗感染治疗,但病情未见改善。转入我科后,通过肺泡灌洗液宏基因组二代测序(metagenomic next-generation sequencing, mNGS)检出鹦鹉热衣原体,确诊为鹦鹉热衣原体肺炎。经左氧氟沙星联合米诺环素治疗后好转出院。通过回顾文献发现,鹦鹉热是一种人畜共患疾病,可累及全身多系统,其中呼吸系统受累最为常见。此病可在人际间传播。宏基因组高通量测序技术相较于血清学、病原体分离培养、聚合酶链反应(polymerase chain reaction, PCR)等传统检测手段具有优越性。治疗首选四环素类药物,疗程为2~3周。该病的预后较好,整体病亡率约为1%。结论:鹦鹉热为人畜共患疾病,需要早期治疗。该疾病临床特征和检查结果缺乏特异性,误诊率和漏诊率均较高。宏基因组高通量测序技术在诊断该病方面具有优势。治疗首选四环素类药物,预后较好。

Development and Evaluation of a MAb-Based ELISA for Detection of Chlamy- dophila pneumoniae Infection with Variable Domain 2 and 3 of the Major Outer Membrane protein

Objective This paper aims to develop a monoclonal antibodies （MAbs）- based ELISA for detecting Chlamydophila pneumoniae （C. pneumonioe） antigens in humans with the variable domains （VD） 2 and 3 of the major outer membrane protein （MOMPvD2-VD~） and to assess its sensitivity and specificity by comparing with a widely used MAb that is able to recognize the elementary bodies of C. pneumoniae. Methods MOMPvo2-vo3were overexpressed in Escherichia coil and purified by affinity chromatography. Mice were immunized with the recombinant antigen, and hybridomas secreting MAbs were screened. Three stable hybridomas clones were selected and named 5D6, 7G3, and 8C9. The MAbs-based ELISA was scrutinized for species-specific recognition with a number of human throat swab samples from Group I （156 patients with typical respiratory illness clinically confirmed before） and Group II （57 healthy donors）. Results In Group I, 55 positive cases were detected by anti-EB MAb-based ELISA, 51 cases were positive by MAbs 5D6-based ELISA, and 33 and 38 cases were positive by MAb 8C9 and 7G3-based ELISA respectively. Of the 57 samples from Group II ＂healthy donors＂, 5 were positive and 52 were negative with both anti-EB and 5D6-based tests, while 2 and 3 positive cases were identified by the other two MAb-based ELISAs respectively. Conclusion The novel MOMPvD2.VD3 MAb-based assay may have higher specificity than the anti-EB MAb, which may possibly be used as an alternative tool for the diagnosis of C. pneumoniae infection.

鹦鹉热衣原体肺炎28例临床特征分析

目的分析经宏基因组二代测序技术(metagenopmic next generation sequencing,mNGS)确诊的28例鹦鹉热衣原体肺炎病人的临床特点。方法回顾性分析2019年10月1日至2022年4月1日长沙市第一医院采用mNGS诊断的28例鹦鹉热衣原体肺炎病人的诊治情况。结果28例病人中10例为女性,18例为男性,中位年龄60岁;27例病人有明确禽类接触史,1例无。重症病例占32.1%,多为有慢性阻塞性肺疾病(COPD)、糖尿病、高血压、冠心病或尿毒症等基础疾病病人。临床表现包括发热(100%)、畏寒(28.6%)、咳嗽、咳痰(71.4%)、气促(53.6%)。外周血中白细胞总数多在正常范围,96.4%的病人中性粒细胞比例增高、淋巴细胞比例降低;96.4%病人PCT升高,所检测病人中ESR和CRP升高者达100%;分别有71.4%和50%病人乳酸脱氢酶和肌酸激酶增高;有82.1%的病人谷草转氨酶增高,有78.6%的病人白蛋白降低。胸部CT表现单侧病变25例、其中右肺病变19例,常见影像改变是斑片状阴影(78.6%)、大片实变(21.4%),26例伴有胸腔积液。治疗情况:单用氟喹诺酮类(莫西沙星或者左氧氟沙星)治疗9例,单用多西环素治疗2例;联合用药13例,其中青霉素类(哌拉西林他唑巴坦或头孢哌酮舒巴坦钠)联用喹诺酮类有10例,青霉素类联合多西环素3例。有2例病人初始选择青霉素类加喹诺酮类药物治疗无效,改用多西环素或联用多西环素后症状缓解。28例病人均预后良好,无死亡病例。结论鹦鹉热衣原体肺炎病人的职业史、临床表现、实验室检查结果及肺部CT具有一定的特点;临床对可疑病例应尽早行mNGS检测,快速过渡到精准治疗,能明显改善预后。

冠心病与微生物慢性感染的血清学研究

目的 :探讨巨细胞病毒 (CMV )、肺炎衣原体 (CP)和幽门螺杆菌 (HP)与冠心病 (CHD)的关系。方法 :应用荧光抗体法和ELISA法检测112例冠心病患者血清C_反应蛋白 (CRP)的水平及巨细胞病毒抗体 (CMVIgM)、肺炎衣原体抗体(CPIgG、CPIgM)和幽门螺杆菌抗体(HPIgG、HPIgM)的阳性率并与对照组比较。结果 :冠心病组与对照组比较CRP差别有统计学意义(t=15.100 ,P<0.01);CMVIgM、CPIgM差别无统计学意义(χ2分别为0.836和0,P>0.05) ;CPIgG、HPIgG和HPIgM差别有统计学意义(χ2 分别为6 590、6 372和7.830,P<0.05) ;经Logistic回归单因素和多因素分析 ,CPIgG、HPIgG与冠心病的有发病有关(均P<0.05)。结论

肺炎嗜衣原体CPAF重组蛋白致小鼠肺组织炎症及对炎症细胞因子的影响

目的：研究肺炎嗜衣原体（Chlamydophila pneumoniae,Cpn）蛋白酶样活性因子（CPAF）的181400aa基因（CPAFm）的重组蛋白在BALB/c小鼠体内引起的肺部炎症改变及对炎症细胞因子TNF-α和IL-6的水平的影响,为进一步探索CPAF在Cpn感染中的致病作用提供实验依据。方法：将纯化的CPAFm重组蛋白于鼻内或尾静脉注射BALB/c小鼠,HE染色观察肺组织病理形态学改变,计小鼠外周血与支气管肺泡灌洗液（Bronchoalveolar lavage fluids,BALF）中白细胞总数,ELISA方法检测血清和BALF中的TNFα-和IL-6的水平。结果：实验组BALB/c小鼠的肺组织出现中性粒细胞、淋巴细胞等炎症细胞浸润,对照组与正常组BALB/c小鼠肺组织未见明显病理改变。鼻内滴入重组蛋白实验组BALB/c小鼠BALF中白细胞总数明显高于GST对照组（P〈0.05）、PBS对照组（P〈0.05）和正常组（P〈0.01）;鼻内滴入和尾静脉注射重组蛋白实验组BALF中炎症因子IL-6、TNF-α的水平明显高于GST、PBS对照组与正常组（均P〈0.01）;鼻内滴入重组蛋白实验组外周血中炎症因子IL-6和TNF-α水平显著高于GST、PBS对照组和正常组（P〈0.05）;尾静脉注射重组蛋白实验组外周血中炎症因子IL-6的水平明显高于相应的对照组（均P〈0.01）。结论：CPAFm重组蛋白有致病性,能引起BALB/c小鼠肺组织的炎症损伤和炎症因子TNF-α、IL-6的水平的升高,肺损伤与BALB/c小鼠体内炎症细胞增多和炎症因子TNF-α、IL-6的水平的升高相关。

肺炎嗜衣原体蛋白酶样活性因子免疫优势区基因重组蛋白在早期诊断中的应用

【目的】克隆和表达肺炎嗜衣原体(Chlamydophila pneumoniae,Cpn)蛋白酶样活性因子(CPAF)免疫优势区基因,评价重组蛋白在早期感染诊断中的应用价值。【方法】挑选并克隆出Cpn CPAF免疫优势区基因,构建原核表达载体,诱导表达并纯化重组蛋白,分析其抗原特异性;间接ELISA法检测Cpn参考血清、临床血清标本中的特异性IgM抗体,以及呼吸道感染患者痰咽拭子中的Cpn抗原;检测沙眼衣原体(Chlamydia trachomatis,Ct)临床阳性血清和泌尿生殖道分泌物。【结果】高效表达和纯化出一相对分子量约51.3kDa的重组蛋白;Westernblot证明其只与人抗Cpn抗血清发生特异性反应;间接ELISA法检测40份CpnIgM参考血清,阴性和阳性结果的一致率均为100%(40/40);与"金标准"方法MIF对照,检测300例临床血清标本中的IgM抗体,符合率为98.3%;与PCR试剂对照,检测120份呼吸道感染患者痰咽拭子中的Cpn抗原,符合率为88.3%;检测Ct阳性血清和泌尿生殖道分泌物,与Ct没有交叉反应。【结论】制备的CPAF免疫优势区基因重组蛋白具有良好的抗原性,在Cpn感染早期诊断中具有较高的利用价值。

肺炎衣原体下调THP-1源性巨噬细胞ABCA1、ABCG1表达的机制研究

目的:观察c-Jun氨基末端激酶(JNK)对肺炎衣原体(Cpn)诱导的THP-1源性巨噬细胞ATP结合盒转运蛋白A1(ABCA1)、ATP结合盒转运蛋白G1(ABCG1)和过氧化物酶体增殖物激活受体γ(PPARγ)表达的调控作用,探讨Cpn下调THP-1源性巨噬细胞ABCA1/ABCG1表达的信号转导机制。方法:将THP-1单核细胞诱导分化为巨噬细胞后,观察Cpn感染对细胞内ABCA1/ABCG1及PPARγ mRNA和蛋白表达的影响。并用不同浓度的JNK特异性抑制剂SP600125对细胞进行预处理,观察SP600125对Cpn诱导的ABCA1/ABCG1、PPARγ mRNA和蛋白表达的影响。分别用RT-PCR和Western blotting检测各组ABCA1/ABCG1及PPARγ mRNA和蛋白表达。结果:Cpn下调THP-1源性巨噬细胞ABCA1/ABCG1及其上游调控基因PPARγ mRNA和蛋白表达。而SP600125能呈浓度依赖性地抑制Cpn感染所带来的上述影响。结论:Cpn可能通过JNK-PPARγ信号转导通路下调AB-CA1/ABCG1表达,减少巨噬细胞内胆固醇流出,促进动脉粥样硬化发生发展。

自制肺炎衣原体单克隆抗体检测其特异性抗原对动脉粥样硬化诊断的临床意义

目的探讨采用自制肺炎衣原体单克隆抗体(Cpn-McAb)检测人外周血单核细胞(PBMC)和冠状动脉瘤标本中肺炎衣原体特异性抗原(Cpn-Ag)的临床意义。方法采用自制Cpn-McAb的直接免疫荧光(DI)法检测颈动脉粥样硬化和健康体检者PBMC中Cpn-Ag及冠状动脉瘤和正常冠状动脉标本中Cpn-Ag的表达。结果颈动脉粥样硬化患者和健康体检者PBMC中Cpn-Ag检测结果间差异有显著性意义(P<0.01);粥样硬化冠状动脉瘤标本和正常冠状动脉标本外膜下和/或斑块内Cpn-Ag检测结果间差异有显著性意义(P<0.01)。冠状动脉瘤标本中有大量Cpn-Ag沉积,分别位于外膜下及粥样硬化斑块内,而正常血管壁中仅有少量沉积(P<0.05)。结论PBMC中的Cpn-Ag的检测可为诊治与该病原体相关的疾病提供依据;Cpn可能是动脉粥样硬化形成的原因之一。

肺炎嗜衣原体Cpn0810重组蛋白诱导THP-1细胞产生促炎因子和凋亡的研究

目的:在E.coliBL21中表达肺炎嗜衣原体Cpn0810,并研究该蛋白能否诱导人单核细胞(THP-1)产生TNF-α和IL-6等促炎因子和细胞凋亡。方法:PCR扩增Cpn0810蛋白编码基因,构建pGEX6p-2/Cpn0810重组质粒,在E.coliBL21中诱导表达,经ToxinEraser纯化柱纯化后,用不同浓度的GST-Cpn0810作用THP-1细胞,ELISA法检测TNF-α和IL-6的水平,Hoechst33258荧光染色、AnnexinV-FITC-PI染色法检测细胞凋亡情况。结果:构建了重组质粒pGEX6p-2/Cpn0810,并在E.coliBL21菌中高效表达。该蛋白能诱导THP-1细胞以时间、剂量依赖方式表达TNF-α和IL-6;当10mg/L GST-Cpn0810处理THP-1细胞24 h后,形态学上,细胞表现为皱缩、核碎裂、细胞起泡及凋亡小体等凋亡特征。结论:表达并纯化的Cpn0810蛋白能诱导THP-1细胞分泌TNF-α和IL-6等促炎因子和诱导其发生凋亡。

LAMP技术在肺部非典型感染病原体检测中的应用

目的探讨利用现代生物技术开发一套可以快速、准确而且高通量检测肺部3种常见非典型感染病原体的检测方法。方法采用环介导等温核酸扩增技术(LAMP)对导致肺部非典型感染的肺炎支原体、肺炎衣原体及嗜肺军团菌3种常见病原体的特异性DNA片段进行扩增,结合基因芯片杂交技术鉴定这3种肺部非典型感染的病原体。结果采用LAMP技术对目的核酸进行扩增,肺炎支原体、肺炎衣原体及嗜肺军团菌3种致病菌特异性核苷酸片段同时布阵在一张芯片上,证明该鉴定系统可检测出的DNA浓度为104拷贝大小,特异性高,芯片质量稳定。结论 LAMP技术结合基因芯片杂交技术可发挥独特的检测优势,能为常见的肺部非典型感染病原体最终鉴定提供进一步佐证,可提高检验鉴定结果的准确性,具有简便快速、灵敏度高、特异性好等优势。

肺炎嗜衣原体Cpn0425重组蛋白的克隆与表达及抗原性研究

目的构建重组质粒pGEX6p-2/Cpn0425,在E.coli BL21中进行诱导表达,纯化获得重组融合蛋白Cpn0425,并评价其抗原性。方法 PCR扩增肺炎嗜衣原体Cpn0425蛋白编码基因,构建pGEX6p-2/Cpn0425重组质粒,测序正确后在E.coli BL21中诱导表达,用SDS-PAGE和Western-Blot进行分析和鉴定。结果构建了重组质粒pGEX6p-2/Cpn0425,并在E.coli BL21菌中高效表达出Mr约为50kDa的GST-Cpn0425目的蛋白,超声裂解后SDS-PAGE分析目的蛋白在菌体细胞内以可溶性形式表达,经采用默克Novagen的GST纯化树脂纯化获得纯度在95%以上的重组蛋白。结论获得了Cpn0425基因片段,并在E.coli BL21中成功表达,GST-Cpn0425具有良好的抗原性。

肺炎嗜衣原体Cpn0147重组蛋白的免疫学活性研究

目的研究Cpn0147重组蛋白的免疫学活性及其应用于肺炎嗜衣原体(Cpn)感染临床诊断中的价值。方法采用GST琼脂糖凝胶纯化目的蛋白,将Cpn0147重组蛋白免疫新西兰兔,分别应用Westernblot、ELISA法检测其免疫反应性及免疫原性,同时通过检测临床标本以评估其诊断价值。结果成功表达并纯化了相对分子质量约41×103的重组蛋白GST-Cpn0147;Westernblot和ELISA结果显示,该重组蛋白具有良好的免疫反应性,动物实验结果表明该重组蛋白具有较好的免疫原性,ELISA结果显示该重组蛋白免疫新西兰兔血清抗体效价为1:12800。结论 Cpn0147重组蛋白具有较好免疫学活性和特异性,可为Cpn感染的确诊、预防研究奠定基础。

衣原体肺炎患者支气管肺泡灌洗液中TNF-α、IL-6及IL-10的检测及临床意义

目的探讨肺炎嗜衣原体患者支气管肺泡灌洗液中TNF-α,IL-6和IL-10的产生情况及临床意义。方法获取肺炎嗜衣原体感染急性患者为研究对象,获取支气管肺泡灌洗液,采用ELISA法检测其TNF-α,IL-6和IL-10的含量,同时选取同期恢复期患者作为对照。结果衣原体急性期患者支气管肺泡灌洗液中TNF-α、IL-6和IL-10显著高于正常对照组。在恢复期内,TNF-α和IL-6明显低于急性期,但IL-10依然维持在较高水平。结论肺炎嗜衣原体感染患者支气管肺泡灌洗液中TNF-α,IL-6和IL-10显著增高,可能与肺炎嗜衣原体的发病有关。

主动脉、桡动脉和内乳动脉粥样硬化与微生物感染的关系

目的:探讨人主动脉、桡动脉和内乳动脉粥样硬化与微生物感染的关系。方法:搭桥手术中成功取得主动脉碎片(全层)30例、桡动脉30例和内乳动脉20例,组织行PCR检测及病理学分析,评估血管病变程度并分级。结果:30例主动脉、30例桡动脉、20例内乳动脉其轻度病变组与重度病变组肺炎衣原体(CPn)、幽门螺旋杆菌(HP)、巨细胞病毒(CMV)的PCR检测阳性率比较,差异均无统计学意义(P>0.05)。结论:CPn、HP、CMV感染与动脉硬化有关,但与主动脉、桡动脉、内乳动脉的动脉病理改变程度无关。

肺炎衣原体感染与急性脑梗死的相关性

目的:探讨肺炎衣原体(Cpn)感染与急性脑梗死发生发展的关系。方法:采用微量免疫荧光法(M IF)检测100例急性脑梗死患者(病例组)与100例同期门诊健康体检者(对照组)肺炎衣原体血清特异性IgG、IgM抗体,并使用全自动生化仪检测血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)浓度及C-反应蛋白(CRP)水平。结果:病例组和对照组肺炎衣原体慢性感染率分别为72.0%、50.0%,差异有显著性(P<0.01)。急性感染率分别为15.0%、12.0%,两组差异无显著性(P>0.05)。病例组血脂水平:TC(6.1±1.48)mm o l/L,TG(2.69±1.91)mm o l/L,LDL-C(3.85±0.25)mm o l/L,HDL-C(1.03±0.56)mm o l/L;对照组TC、TG、LDL-C、HDL-C水平分别为(4.22±0.43)mm o l/L,(1.08±0.25)mm o l/L,(2.48±0.65)mm o l/L,(1.15±0.59)mm o l/L;两组CRP水平分别为:(13.72±5.30)m g/L,(5.61±2.4)m g/L;两组在血脂、CRP水平比较差异有显著性(P<0.01)。在病例组中,肺炎衣原体阳性者(感染组)血清TC、TG浓度及CRP水平高于阴性者(非感染组)(P<0.05),HDL-C浓度略低于非感染组,但差异无显著性(P>0.05)。结论:肺炎衣原体慢性感染与脑梗死发病有一定的相关性,血清中的CRP和肺炎衣原体抗体水平升高提示炎症反应增强。

天津地区老年社区获得性肺炎住院患者的病原学分析

目的了解天津地区老年社区获得性肺炎(CAP)住院患者的病原学特点,为本地区CAP的经验性治疗提供依据。方法收集2008年4月至2009年3月以CAP为诊断的老年住院患者120例,采集痰、支气管吸出物和血标本,采用痰定量培养、血清学及聚合酶链反应方法,进行细菌、肺炎支原体和肺炎衣原体检测。结果 120例CAP患者中,病原学检测阳性64例(53.3%),其中肺炎支原体28例(23.3%),肺炎衣原体1例(0.8%)。痰培养检测出可分析致病菌45例(37.5%),居首位的细菌是肺炎链球菌15例(12.5%)。混合感染10例(8.3%)。支原体肺炎在老年患者中冬春季节发病率较高,但患有基础疾病的患者发病率相对较低。结论在天津地区老年CAP住院患者中,肺炎支原体是最常见致病菌,肺炎链球菌也是重要致病菌,衣原体肺炎发病率低于其他地区的报道。该地区发病特点值得多关注。