肺炎衣原体抗体IgA与动脉粥样硬化及再狭窄的相关性分析

目的 :探讨肺炎衣原体感染和炎症对冠状动脉 (冠脉 )粥样硬化和支架内再狭窄的影响。方法 :6 2 8例接受冠脉造影检查的患者根据造影结果分为冠脉粥样硬化组 (4 33例 )和非冠脉粥样硬化组 (195例 ) ,记录两组基线临床资料 ,检测血清肺炎衣原体抗体IgA及高敏的C反应蛋白 (CRP)。 2 6 1例冠脉内放置支架的患者分为感染组 (89例 )和非感染组 (172例 ) ,随访半年 ,再次冠脉造影检查 ,测量支架内管腔丢失率。结果 :冠脉粥样硬化组肺炎衣原体抗体IgA的阳性率及滴度均高于无冠脉粥样硬化组 (4 8.32 %∶2 6 .10 % ;1.31± 1.19∶0 .92± 1.12 ) ;血清CRP水平明显升高 [(34.6 7± 3.2 4 )mg/L∶(2 3.2 2± 3.2 7)mg/L],且随着病变程度加重而增加。肺炎衣原体感染组和非感染组再狭窄发生率分别为 2 7.0 %、2 1.3% ,差异无统计学意义。但有再狭窄者血清CRP水平明显高于无再狭窄者 [(36 .13± 4 .0 4 )mg/L∶(16 .5 1± 3.92 )mg/L]。 结论 :血清抗肺炎衣原体抗体IgA阳性与冠脉粥样硬化相关 ,但不能预示支架内再狭窄的发生 ;而CRP与冠脉粥样硬化和再狭窄的发生均相关 ,提示炎症反应不仅在动脉粥样硬化而且在支架内再狭窄的发生中均扮演重要角色。     

炎症反应肺炎衣原体感染与冠心病的临床相关性研究

目的对白细胞介素-6(IL-6)、C-反应蛋白(CRP)、纤维蛋白原(Fg)、肺炎衣原体感染(Cpn)与冠心病(CHD)间的关系进行探讨研究。方法选取2015年1月~2016年1月我院收治的急性心肌梗死患者41例为研究对象,作为AMI组,以冠状动脉造影证实心绞痛患者41例作为本次研究AP组,取健康体检者41名作为本次研究对照组。采用相应的检测方法测定三组对象体内IL-6、CRP、Fg、Cpn各项指标并行组间比较。结果 AMI组IL-6、CRP、Fg水平、Cpn-Ig G阳性率均高于对照组,AP组IL-6、CRP、Fg水平、Cpn-Ig G阳性率均高于对照组,差异有统计学意义(P0.05)。结论通过炎症反应强度能了解冠心病患者病变程度,Cpn慢性感染,冠心病二者存在一定相关性,在冠心病的发生发展过程中可能有Cpn慢性感染参与。     

老年冠心病患者血清脂联素及肺炎衣原体抗体等水平的观察

目的 探讨老年冠心病(CHD) 患者血清脂联素、肺炎衣原体(Cpn)抗体及细胞间黏附分子-1 (ICAM-1)等水平的变化及其临床意义. 方法 临床确诊的老年CHD病人300例,以342例健康查体者为对照组,放免法测定其血清脂联素,ELISA法检测血清Cpn抗体及ICAM-1、C反应蛋白(CRP)、白介素-6(IL-6)水平,同时对其作血脂分析. 结果 老年CHD患者血清Cpn IgA抗体阳性率显著高于对照组(P＜0.01),IgM抗体则与对照组无显著差异;急性心肌梗死(AMI)及不稳定型心绞痛(UAP)者Cpn IgG抗体阳性率明显高于对照组(P＜0.05).CHD病人血清脂联素明显低于对照组(P＜0.01),而ICAM-1、CRP及IL-6则明显高于对照组(P＜0.05). 结论 Cpn抗体高阳性率及脂联素的降低与老年冠心病之间存在联系,而患者血清ICAM-1、CRP及IL-6水平的升高也提示炎症反应在冠心病的发生发展中起着重要作用.     

颈动脉粥样硬化斑块严重程度与血清CRP、IL-6、TNF-α水平的关系

目的探讨颈动脉粥样硬化斑块严重程度与患者血清C反应蛋白（CPR）、白细胞介素-6（IL-6）、肿瘤坏死因子（TNF-α）的关系。方法检测30例健康对照者、30例I级斑块、30例Ⅱ级斑块、30例Ⅲ级斑块患者血清CRP、TNF-α、IL-6水平并进行对照，分析各指标与颈动脉粥样硬化斑块严重程度的关系。结果颈动脉粥样硬化斑块患者血清CRP、IL-6、TNF-α水平高于对照组（P均〈0．01）；Ⅱ、Ⅲ级斑块患者CRP、TNF-α、IL-6水平明显高于I级患者（P均〈0．05）。结论血清ERP、TNF-α、IL-6水平增高与颈动脉粥样硬化斑块严重程度密切相关。     

炎症反应肺炎衣原体感染与冠心病的临床相关性研究

目的 :探讨白细胞介素 6 (IL 6 )、C 反应蛋白 (CRP)、纤维蛋白原 (Fg)及肺炎衣原体 (Cpn)感染与冠心病 (CHD)间的关系。方法 :急性心肌梗死 (AMI)组、经冠状动脉造影证实的心绞痛 (AP)组及正常对照各 30例。应用放射免疫法检测血清IL 6浓度 ,散射免疫浊度法检测血浆Fg及血清CRP水平 ,并用微量免疫荧光法检测血清Cpn特异性抗体IgG、IgM滴度并检测呼吸道合胞病毒特异性抗体IgG滴度做对照。 结果 :AMI组和AP组的血清IL 6、CRP及血浆Fg水平显著高于对照组 (均P<0 .0 1)。血清IL 6、CRP及血浆Fg水平彼此显著相关 (r值分别为 0 .81、0 .80和 0 .6 8,均P <0 .0 1) ,三者水平与AP患者的冠状动脉狭窄危险分数相关。AMI组、AP组血清抗CpnIgG抗体阳性率显著高于对照组 (分别 P <0 .0 1、<0 .0 5 )。三组的Cpn特异性IgM抗体与抗呼吸道合胞病毒IgG抗体阳性率比较差异无显著性意义。抗CpnIgG抗体阳性者IL 6、CRP水平显著高于阴性者。Cpn感染者特异性抗体IgG滴度与血中IL 6、CRP及Fg水平均明显相关。 结论 :炎性细胞因子及其诱生的急性相蛋白与CHD发生发展密切相关 ,炎症反应强度可能反映CHD病变程度。Cpn慢性感染与CHD相关 ,并可能通过介导炎症反应参与CHD发生发展     

肺炎衣原体感染对冠心病发病影响的临床观察

目的 研究肺炎衣原体(Cpn)感染与冠心病(CHD)的关系.方法 应用酶联免疫吸附试验(ELISA)测定冠心病组(120例)和对照组(111例)血清Cpn特异性抗体IgM、IgG及IgA,同时应用免疫浊度法测定冠心病组(97例)和对照组(95例)血清C-反应蛋白(CRP)含量.结果 冠心病组血清Cpn抗体IgG和/或IgA阳性率及IgG和IgA滴度明显高于对照组(均P<0.05);急性心肌梗死(AMI)、不稳定型心绞痛(UAP)及慢性冠心病(CCHD)患者血清Cpn抗体IgG及IgA滴度均分别高于对照组(均P<0.05);冠心病组Cpn抗体IgM阳性率及滴度与对照组无明显差异;IgG和/或IgA及CRP均为阳性组的冠心病发生率明显增高;多元回归分析显示Cpn慢性感染与冠心病发病呈正相关(P=0.045),Cpn慢性感染与冠心病其他危险因素间无相关性.结论Cpn慢性感染可作为冠心病的独立危险因素,炎症反应的发生可能是Cpn慢性感染导致动脉粥样硬化的关键环节.     

冠心病合并2型糖尿病行PCI术前后hsCRP的对比性研究

目的探讨冠心病合并2型糖尿病患者冠脉病变程度与C-反应蛋白（CRP）的关系及经皮冠状动脉介入治疗（PCI）后的变化。方法采用酶联免疫吸附试验（ELISA）测定经皮冠状动脉造影（CAG）确诊并行PCI术的患者及32例CAG正常者的血清hsCRP水平，并比较不同冠脉病变程度者其血清值及PCI术后的变化。结果研究组中的双支及多支病变组明显高于正常对照组，PCI术后显著高于术前。结论血清hsCRP水平与冠心病合并2型糖尿病冠脉病变程度密切相关。在冠脉粥样硬化的过程中有炎症反应参与，在PCI术后应加强干预。     

冠心病患者IL-6及CRP血清水平检测的临床意义

目的 探讨白细胞介素-6(IL-6)血清水平和C-反应蛋白(CRP)在监测冠心病病情及与冠状动脉病变程度的关系.方法 142例冠心病患者,按临床诊断分为急性心肌梗死(AMI)组48例、不稳定性心绞痛(UAP)组45例、稳定性心绞痛(SAP)组49例,对照组50例.采用免疫透射比浊测定CRP,用酶联免疫吸附实验检测血清IL-6的水平.比较各组间的差异.结果 AMI组、UAP组及SAP组的CRP及IL-6水平均比对照组高(P<0.05);AMI组、UAP组ClIP及IL-6水平和SAP组相比,其值增加明显;AMI组和UAP组结果相似;IL-6水平与CRP变化呈正相关.结论 血清CRP及IL-6可能是冠状动脉粥样硬化的标志,参与了冠心病的发病过程,其值与冠状动脉病变程度密切相关.     

冠心病患者介入治疗前后白细胞介素-8、血浆P选择素和C反应蛋白变化研究

目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者介入治疗前后血浆白细胞介素-8(interleukin-8,IL-8)、C反应蛋白(C-reactive protein,CRP)和P选择素(P-selection,PS)的变化及其与冠心病严重程度间的相关性。方法酶联免疫吸附法测定78例冠脉介入治疗者(治疗组)和46例冠脉造影者(对照组)治疗前后1hIL-8、CRP和PS的血浆浓度,比较治疗前后各指标变化。结果治疗组介入治疗后IL-8、CRP和PS较治疗前明显升高(P<0.05);对照组冠脉造影前后IL-8、CRP和PS无明显变化(P>0.05)。多支病变患者IL-8、CRP和PS水平明显高于单支和双支病变患者(P<0.05)。结论冠心病患者介入治疗后血浆IL-8、CRP和PS短期内显著增高。IL-8、CRP和PS水平与冠心病严重程度存在相关性。     

脂蛋白相关磷脂酶A2与临床冠心病的关系

目的探讨冠心病患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)与冠状动脉(冠脉)炎症反应程度的关系。方法102例经冠脉造影证实的患者纳入冠心病(CHD)组,其中稳定型心绞痛(SAP)41例,不稳定型心绞痛(UAP)30例,急性心肌梗死(AMI)31例,对照组38例为冠脉造影正常的非冠心病者。所有对象造影前采集血标本以检测Lp-PLA2、C反应蛋白(CRP)和白细胞介素6(IL-6)。结果(1)冠心病组血清Lp-PLA2、CRP和IL-6均高于对照组(P<0.01);(2)AMI组与UAP组血清Lp-PLA2、CRP、IL-6比较差异无显著性(P>0.05),但均高于SAP组(P<0.01),在校正了心血管危险因素后差异仍有统计学意义;(3)经双变量相关性分析,血清Lp-PLA2水平与CRP、IL-6水平呈显著相关(r=0.722、0.665,P<0.01)。结论血清Lp-PLA2水平能反映冠脉炎症活动性状况,对冠心病的病情判断有一定价值。     

血清C反应蛋白和尿酸与冠状动脉病变程度的相关性研究

目的探讨血清C反应蛋白、尿酸(UA)水平与冠状动脉病度程度的相关性。方法选择2009年6月—2011年6月在赤峰市医院住院的疑似冠心病患者502例,根据冠状动脉造影结果分为观察组(378例)和对照组(124例),观察组又分为3个亚组:单支病变组152例,双支病变组121例,三支病变组105例,分别测定血清CRP和UA水平,观察其与冠状动脉病变程度的相关性。结果观察组血清CRP和UA水平均明显高于对照组,差异有统计学意义(P<0.05);血清CRP和UA水平越高,冠状动脉病变越重,与之呈正相关。结论冠心病的发生和冠状动脉病变的严重程度与血清CRP、UA水平密切相关。     

冠心病患者血清C反应蛋白和可溶性细胞间粘附分子1与肺炎衣原体感染的相关性

目的探讨冠心病患者血清炎症标志物C反应蛋白和可溶性细胞间粘附分子1水平的变化及其与肺炎衣原体感染的关系。方法采用酶联免疫吸附法检测60例急性心肌梗死、不稳定型心绞痛、陈旧性心肌梗死、稳定型心绞痛及40例对照者血清C反应蛋白、可溶性细胞间粘附分子1及肺炎衣原体抗体IgG、IgM。结果冠心病组肺炎衣原体IgG阳性率和浓度均高于对照组(P<0.01),冠心病各组之间肺炎衣原体IgG和IgM阳性率差异无显著性(P>0.05),急性心肌梗死组肺炎衣原体IgG浓度高于陈旧性心肌梗死组、不稳定型心绞痛组和稳定型心绞痛组(P<0.05);冠心病组C反应蛋白、可溶性细胞间粘附分子1水平高于对照组(P<0.01),急性心肌梗死组C反应蛋白、可溶性细胞间粘附分子1水平高于不稳定型心绞痛组、陈旧性心肌梗死组和稳定型心绞痛组(P<0.01),不稳定型心绞痛组C反应蛋白、可溶性细胞间粘附分子1水平高于稳定型心绞痛组(P<0.05);肺炎衣原体IgG浓度、C反应蛋白、可溶性细胞间粘附分子1之间有很好的相关性(P<0.05)。结论炎症标志物水平变化在一定程度上反映了冠心病患者病情变化,肺炎衣原体感染与冠心病有关,炎症、感染可能共同参与了冠心病的发生发展。     

Association of Chlamydia pneumoniae infection and carotid intima-media wall thickness in Japanese Americans.

BACKGROUND: Chlamydia pneumoniae (Cp) infection has been proposed as a risk factor for coronary artery disease (CAD), but it remains unclear whether Cp plays a role in the progression of early stage carotid atherosclerosis. METHODS AND RESULTS: The associations among Cp IgG/IgA antibodies, inflammation markers such as C-reactive protein (CRP) and interleukin (IL)-6, and the maximal progression of carotid intima-media wall thickness (max IMT) were evaluated using ultrasonography in 259 Japanese Americans. The presence of Cp IgG or IgA antibodies itself did not show significant correlation with max IMT after adjustment for age and sex. However, in the Cp IgG seropositive group, the subjects with high IL-6 levels showed more pronounced max IMT progression than those with low IL-6 levels after adjustment of the other CAD risk factors. Moreover, in the Cp IgA seropositive group, the subjects with high CRP or IL-6 levels had significantly higher levels of max IMT compared with those with low CRP or IL-6. CONCLUSIONS: The results support the hypothesis that a chronic latent Cp infection with inflammation might accelerate the development of early stage atherosclerotic lesions.     

Acute-phase proteins and Chlamydia pneumoniae infection: which one is more important in acute coronary syndrome?

Elevated levels of acute-phase proteins, a systemic marker for inflammation, predict coronary events; Chlamydia pneumoniae (C. pneumoniae) infection is associated with coronary atherosclerosis. The present study investigated whether inflammation or infection is involved in the pathogenesis of acute coronary syndrome (ACS) and which one has the more important role. The study group comprised 49 patients with angiographically diagnosed ACS, 48 cases of chronic coronary heart disease (CCHD), and 44 subjects with a normal coronary profile. The levels of serum C-reactive protein (CRP), fibrinogen and anti-C. pneumoniae IgG antibody were measured. The IgG antibody against C. pneumoniae was higher in the ACS and CCHD groups compared with the control group after adjusting for age and gender. The levels of CRP and fibrinogen were significantly increased in patients with ACS compared with controls and CCHD patients. Multiple stepwise logistic regression analysis revealed that C. pneumoniae IgG antibody is an independent risk factor for both ACS and CCHD (odds ratio 2.3 and 2.1, respectively), but the CRP level is a risk factor only for ACS (odds ratio 6.9). The inflammatory response, as indicated by acute-phase proteins, especially CRP, rather than C. pneumoniae infection, may contribute more to the clinical course of ACS.     

Acute Chlamydia pneumoniae infection with heat-shock-protein-60-related response in patients with acute coronary syndrome

Recent evidence has suggested an association between Chlamydia pneumoniae infection and coronary atherosclerosis. A significant association has also been detected between heat shock protein (HSP) 60 antibody and the severity of coronary atherosclerosis. The aim of this study was to define the relationship between instability of ischemic heart disease (IHD) and serum levels of HSP60 and C. pneumoniae antibodies. Blood samples for the measurement of serum antibody titers were obtained from 1131 patients with ischemic heart disease (65+/-9 years; male/female, 828/303) and 127 non-IHD controls with normal coronary arteries (64+/-9 years; male/female, 60/67) on the day of cardiac catheterization. The serum levels of anti-human HSP60 IgG antibody and anti-chlamydial IgM, but not IgG or IgA, antibody were significantly higher in ACS patients than in stable IHD patients or controls. These results suggest that acute C. pneumoniae infection with HSP60-related immunological responses may contribute to the pathophysiology of acute coronary syndromes.     

Relationship of Chlamydia pneumoniae infection to severity of coronary atherosclerosis in patients with chronic coronary artery disease and with normal coronary arteries]

OBJECTIVES: Recent studies have demonstrated an association between infection with Chlamydia (C.) pneumoniae and coronary artery disease. However, the association is less clear in the Japanese population. The relationship of C. pneumoniae infection to severity of coronary atherosclerosis was investigated in patients with chronic coronary artery disease and with normal coronary arteries. METHODS: Serum levels of IgA and IgG antibodies to C. pneumoniae outer membrane complex were measured by enzyme-linked immunosorbent assay and C-reactive protein (CRP) analyses in 130 patients who underwent coronary angiography. Patients with unstable angina and recent myocardial infarction were excluded. Results were divided into three groups according to Gensini coronary score (GCS): normal (n = 19, GCS = 0); mild atherosclerosis (n = 56, GCS = 1-19); and severe atherosclerosis (n = 55, GCS > or = 20). RESULTS: Cut off indices of IgA and IgG in the atherosclerosis groups (severe: 1.53 +/- 0.72 and 1.67 +/- 0.97, mild: 1.58 +/- 0.92 and 1.42 +/- 0.86, respectively) were higher than in the normal group (1.22 +/- 0.59 and 1.28 +/- 0.82), but there were no significant differences. There were no correlations between indices of IgA and IgG, and GCS. The normal CRP group (n = 118, < 0.3 mg/dl) and the high CRP group (n = 12, > or = 0.3 mg/dl) showed no differences in IgA and IgG indices and GCS. CONCLUSIONS: Serum antibody indices against C. pneumoniae are not associated with the severity of coronary atherosclerosis in chronic stable coronary artery disease.     

Role of Chlamydia, mycoplasma and cytomegalovirus infection in the development of coronary artery disease

AIM: To assess relationship between some infection factors and presence of coronary heart disease. MATERIAL: Patients with myocardial infarction (n=56), unstable angina (n=50), stable angina (n=50) and age - matched controls (n=49). METHODS: Levels of IgG, IgM, IgA antibodies to Chlamydia pneumonia, Chlamydia trachomatis, Chlamydia psittaci, IgG, IgM antibodies to Cytomegalovirus, and also of antibodies and antigen to Mycoplasma pneumoniae were measured in blood serum. RESULTS: Compared with controls patients with coronary heart disease had higher frequency of seropositivity to Chlamydia pneumonia, Mycoplasma pneumonia and Cytomegalovirus (p< 0.05 ) and similar levels of seropositivity to Chlamydia trachomatis and Chlamydia psittaci. Infectious burden (quantity of antibodies per one patient) was significantly higher in patients with myocardial infarction, unstable and stable angina than in controls (1.58, 1.42, 1.41 and 0.95, respectively). CONCLUSION: Our results confirm presence of association between infection and coronary heart disease.     

糖化血红蛋白和C-反应蛋白与冠状动脉病变的相关性

目的探讨冠心病患者冠状动脉病变程度与血清糖化血红蛋白(HbA1c)、C-反应蛋白(CRP)水平之间的关系及其临床意义。方法 293例患者按照冠状动脉造影结果分为冠心病组及非冠心病组。冠心病组根据冠状动脉病变支数分为单支病变组、双支病变组、多支病变组,并根据Gensini积分对冠状动脉病变程度进行评分并分级,分析糖化血红蛋白及C-反应蛋白水平与冠状动脉病变的相关性。结果冠心病组血清CRP及HbA1c水平明显高于非冠心病组[(4.93±8.05)mg/L vs(2.21±2.70)mg/L,(5.73±1.28)%vs(5.28±0.78)%],差异均有统计学意义(P<0.05)。年龄、低密度脂蛋白、CRP及HbA1c与冠心病密切相关(OR=1.05～2.36,均P<0.05)。冠心病组CRP及HbA1c水平与Gensini积分呈正相关(r=0.12～0.15,均P<0.05)。结论 CRP及HbA1c联合检测对冠状动脉病变程度有较高的预测价值。     

肺炎衣原体感染对老年患者冠状动脉粥样硬化及再狭窄的影响

目的　探讨肺炎衣原体感染和炎症对老年患者冠状动脉粥样硬化和支架内再狭窄的影响。方法　 5 5 5例接受冠状动脉造影检查的患者根据造影结果分为冠状动脉粥样硬化组和无冠状动脉粥样硬化组 ,检测血清肺炎衣原体抗体IgA及C反应蛋白 (CRP)。 89例放置冠状动脉内支架的患者分感染组和非感染组 ,随访半年 ,再次行冠状动脉造影检查 ,测量支架内管腔丢失率。结果　冠状动脉粥样硬化组肺炎衣原体抗体IgA的阳性率及滴度显著高于非冠状动脉粥样硬化组 ;血清CRP水平明显升高 ,且随着病变程度加重而增加。肺炎衣原体感染组和非感染组内膜增厚发生率差异无显著性意义。但内膜增厚者血清CRP水平明显高于无内膜增厚者。结论　肺炎衣原体感染与冠状动脉粥样硬化相关 ,但不能预示支架内再狭窄的发生 ;而炎症标志物与冠状动脉粥样硬化和再狭窄的发生均相关。     

Chlamydia pneumoniae infection and inflammation in adults with asthma

BACKGROUND: Chlamydia pneumoniae infection and immune response to the C. pneumoniae heat shock protein 60 (CpHsp60) have been suggested to be associated with asthma. OBJECTIVES: To study whether a slightly elevated C-reactive protein (CRP) level as a marker of low-grade systemic inflammation has a role in this association, we collected serum and sputum samples from 103 asthma patients with disease severity ranging from mild to moderate and from 30 healthy volunteers. METHODS: IgA and IgG antibodies to C. pneumoniae elementary bodies (CpEB) and CpHsp60 were measured by enzyme immunoassay. Serum CRP levels were measured with a rapid two-site ultra-sensitive assay based on time-resolved immunofluorometry. RESULTS: The asthma patients, especially those with moderate asthma, had higher serum IgA antibody levels to CpHsp60 than the healthy controls (test for trend, p = 0.05), whereas antibody levels to CpEB antigen did not differ between the study groups. CRP levels were higher in both asthma groups compared to the control group and moreover, the patients with moderate asthma had higher CRP levels than those with mild asthma (test for trend, p < 0.01). The subjects with a slightly elevated CRP level, defined as > or =1.8 mg/l, had higher CpEB IgA (p = 0.001), CpEB IgG (p = 0.008) and CpHsp60 IgA (p = 0.023) antibody levels in serum compared to the subjects with lower CRP levels. CONCLUSIONS: Slightly elevated CRP levels as a marker of low-grade systemic inflammation may be associated with C. pneumoniae infection in asthma patients.