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目的探索血清中肺炎衣原体、幽门螺杆菌抗体阳性及炎性标志物与冠状动脉扩张症之间的关联性。方法在2005年7月至2006年5月济宁市第一人民医院经冠状动脉造影确诊的缺血性心脏病患者87例,分为血管扩张但不伴动脉粥样硬化者31例为冠状动脉扩张组,无冠状动脉扩张者56例作为对照组。用ELISA法检测血清中肺炎衣原体IgM、IgG,幽门螺杆菌IgA、IgG,白介素-6(IL-6),用微粒增强免疫比浊法测定超敏C-反应蛋白(hsCRP)。结果冠状动脉扩张组30例血清肺炎衣原体IgG抗体阳性,占冠状动脉扩张组总例数的97%;对照组阳性者40例,占71%(P<0.01)。冠状动脉扩张组25例肺炎衣原体IgM阳性,占81%;对照组26例阳性,占46%(P<0.01)。冠状动脉扩张组12例幽门螺杆菌IgA阳性,占39%;对照组27例阳性,占48%(P=0.503)。与对照组相比,冠状动脉扩张组血清中hsCRP升高[(5.639±3.530)mg/L对(4.390±3.560)mg/L,P=0.032]。结论肺炎衣原体感染与冠状动脉扩张症之间存在相关性,且伴有hsCRP的升高,提示在冠状动脉扩张症的发病机制中,可能有感染因素参与。
Objective To explore the relationship between serum Chlamydia pneumoniae, Helicobacter pylori antibody positive and inflammatory markers and coronary artery dilatation. Methods From July 2005 to May 2006, 87 cases of ischemic heart disease confirmed by coronary angiography in Jining First People’s Hospital were divided into two groups: 31 cases with vasodilation but not with atherosclerosis Group, no coronary dilatation in 56 cases as a control group. Serum levels of Chlamydia pneumoniae IgM, IgG, Helicobacter pylori IgA, IgG, interleukin-6 (IL-6) were measured by ELISA and hypersensitive C-reactive protein (hsCRP) was measured by microparticle-enhanced immunoturbidimetry. Results Serum C. pneumoniae IgG antibody was positive in 30 cases of coronary artery dilatation group, accounting for 97% of the total cases of coronary artery dilatation group and 40 cases in the control group (71%, P <0.01). 25 cases of coronary artery dilatation group of Chlamydia pneumoniae IgM positive, accounting for 81%; control group 26 cases were positive, accounting for 46% (P <0.01). Helicobacter pylori IgA was positive in 12 cases of coronary artery dilatation group, accounting for 39%; in the control group, 27 cases were positive, accounting for 48% (P = 0.503). Compared with the control group, serum hsCRP was significantly increased in patients with coronary artery dilation [(5.639 ± 3.530) mg / L vs (4.390 ± 3.560) mg / L, P = 0.032]. Conclusions There is a correlation between Chlamydia pneumoniae infection and coronary artery dilatation, and accompanied with the increase of hsCRP, suggesting that infection may be involved in the pathogenesis of coronary artery dilatation.