冠心病患者抗磷脂抗体与人巨细胞病毒感染关系的初步研究

目的 :研究抗磷脂抗体与冠心病的相关性 ,探讨人巨细胞病毒 (HCMV)感染与冠心病患者抗心磷脂抗体 (ACA)产生的关系。　　方法 :76例冠心病患者分为急性心肌梗塞组 (n=2 3) ,陈旧性心肌梗塞组 (n=2 7) ,不稳定性心绞痛组 (n=2 6 ) ;采用酶联免疫吸附试验法检测血清抗心磷脂抗体—免疫球蛋白 G(ACA- Ig G)、人巨细胞病毒—免疫球蛋白 G(HCMV- Ig G)、人巨细胞病毒—免疫球蛋白 M(HCMV- Ig M) ,并与正常对照组 (n=30 )进行比较。　　结果 :76例冠心病患者 ACA的阳性率为 35 .5 3% ,显著高于正常对照组的 6 .6 7% (P<0 .0 5 ) ,而急性心肌梗塞组、陈旧性心肌梗塞组、不稳定性心绞痛组 3组间 ACA的阳性率无差异。全部患者 HCMV的感染情况高于正常对照组 ,HCMV感染的冠心病患者 ACA的阳性率显著高于 HCMV未感染的冠心病患者 (P<0 .0 5 )。　　结论 :抗磷脂抗体可能是促使冠心病发生的免疫因素之一 ;HCMV不仅与冠心病的发生有关 ,而且与冠心病患者ACA的产生有密切关系。     

2型糖尿病动脉粥样硬化与巨细胞病毒感染及内皮素、肿瘤坏死因子的相关性研究

目的　 (1)从流行病学的角度观察人类巨细胞病毒 (HCMV)与 2型糖尿病 (T2 DM)动脉粥样硬化 (AS)的关系 ;(2 )了解血浆内皮素 (ET)、血清肿瘤坏死因子 (TNF- α)在 T2 DM AS发生、发展中的作用及 HCMV感染与 ET、TNF- α的关系。　方法　采用酶联免疫吸附法测定 T2 DM中有 AS患者 2 1例 ,无明显 AS患者 4 7例及正常对照组 2 0例血清 HCMV抗体 Ig M和 Ig G。用放免法测定血清 TNF- α和血浆 ET的浓度。　结果　 (1) T2 DM患者的 HCMV感染率 [阳性率 Ig G为 93% (6 3/ 6 8)、Ig M为 4 6 %(31/ 6 8) ]高于正常人群 [阳性率 Ig G为 80 % (16 / 2 0 )、Ig M为 10 % (2 / 2 0 ) ],检测抗 HCMV- Ig M(抗 Ig M作为活动性感染或潜伏感染活化指标 )更有意义 (P<0 .0 1)。T2 DM患者 ET的浓度 (6 8.6 8± 17.12 ) ng/L 和 TNF- α的浓度 (1.79± 0 .4 3) μg/ L,也高于正常人 [(49.0 4± 14 .36 ) ng/ L、(1.32± 0 .4 1) μg/ L,P均 <0 .0 0 1]。 (2 ) T2 DM伴有 AS患者中 ,活动性或潜伏感染活化 HCMV感染率 (Ig M阳性率 5 7% )和血浆 ET[(86 .77± 15 .19) ng/ L]、血清 TNF- α[(2 .0 1± 0 .4 5 ) μg/ L]的水平高于不伴有 AS的 T2 DM患者 [Ig M阳性率 4 0 % ,ET为 (6 0 .5 9± 10 .4 9) ng/ L,TNF- α为 (1.6 8     

糖尿病合并动脉粥样硬化血清抗人巨细胞病毒抗体检测

目的　明确巨细胞病毒感染与糖尿病动脉粥样硬化形成的关系。方法　用 ELISA方法检测了 56例糖尿病合并冠心病 (A组 )及48例未合并冠心病组的 (B组 )血清人巨细胞病毒 (HCMV) Ig G、 Ig M抗体。结果　 A组患者 HCMV Ig G、 Ig M阳性率均明显高于 B组 ,而且 A组女性患者 HCMV感染率明显高于 B组女性患者。结论　 HCMV可能在糖尿病患者 (尤其是女性患者 )动脉粥样硬化形成过程中发挥重要作用 ,CMV抗体阳性率有可能成为预测女性糖尿病患者发生大血管并发症的指标     

人巨细胞病毒在冠心病发病中的意义及致病机制的研究

目的 :探讨人巨细胞病毒 (HCMV)在冠心病 (CHD)发病中的意义及可能的致病机制。方法 :对 CHD(80例 )包括急性冠状动脉事件患者 (A组 ,5 9例 )和症状稳定患者 (B组 ,2 1例 ) ,和非 CHD患者 (对照组 ,2 6例 )进行外周血 HCMV- Ig M、Ig G、C-反应蛋白 (CRP)检测。结果 :HCMV - Ig M阳性率、Ig G阳性率、CRP阳性率及CRP均值在 CHD组与对照组间差异有显著性意义 (P <0 .0 5 ) ,在 A组与对照组间差异有非常显著性意义 (P<0 .0 1) ,而 B组与对照组间差异无显著性意义 (P>0 .0 5 )。CRP均值在急性心肌梗死中明显高于不稳定心绞痛(P <0 .0 5 )。 A组中 HCMV- Ig M与 CRP间存在相关性 (r =0 .336 )。结论 :HCMV的感染与激活在 CHD的急性冠状动脉事件发病中具有一定意义 ,其发病机制与急性炎症反应有关。外周血 HCMV- Ig M及 CRP检测可作为急性冠状动脉事件早期诊断指标之一 ,定量 CRP检测可作为病情发展判断指标之一。     

急性心梗患者人类巨细胞病毒感染研究

感染与冠心病的关系 ,近年来受到关注。大量临床病理与流行病学研究及实验室检查均提示感染与冠心病的发生发展有关〔1〕。人类巨细胞病毒 (HCMV)在人群中感染十分普遍 ,研究证明 HCMV与动脉粥样硬化密切相关〔2〕。我们检测急性心肌梗塞 (AMI)病人血清 HCMV特异性 Ig M(HCMV-Ig M)和 Ig G(HCMV- Ig G)水平 ,并与病毒性心肌炎 (VMC)病人和健康人相比较 ,以期了解 HCMV感染与 AMI的关系。1　材料的方法1.1　研究对象　 AMI组 :取自我院住院患者 45例 ,其中男34例 ,女 11例 ,平均年龄 6 4± 12岁。AMI诊断符合 WHO标准。…     

高血压患者人巨细胞病毒感染率及其血浆中和抗体水平的分析

目的分析高血压患者人巨细胞病毒感染率及其血浆中和抗体水平,研究人巨细胞病毒感染与高血压的关系。方法选择我院2014年8月至2015年8月收治的高血压患者62例作为研究对象,设为观察组,选择同期在我院进行体检的健康者50名作为对照组,探讨人巨细胞病毒感染与高血压的关系。结果观察组患者HCMV的阳性率与对照组对比,差异有统计学意义(P0.05);观察组HCMV UL93 DNA、HCMV Ig G、HCMV Ig M阳性率与对照组对比,差异均有统计学意义(P0.05);观察组HCMV特异性中和抗体集合滴度与对照组对比,差异有统计学意义(P0.05)。结论人巨细胞病毒感染与高血压之间有着密切联系,人巨细胞病毒参与感染者高血压的形成和发展。     

人巨细胞病毒感染与大肠癌临床相关性

目的:探讨大肠癌患者人巨细胞病毒(human cytomegalovirus,HCMV)感染情况及其临床相关性.方法:采用化学发光(CLIA)法对大肠癌组(n=60)、大肠息肉组(n=60)及健康对照组(n=60)的外周血清进行HCMV免疫球蛋白G(immunoglobulin G,Ig G)、Ig M抗体检测;巢式PCR技术结合原位杂交方法检测32例大肠癌组织及癌旁正常肠黏膜组织中HCMV-UL138基因表达;用Fisher确切概率法比较两组间阳性率,均数比较采用t检验或单因素方差分析.P0.05为差异有统计学意义.结果:大肠癌组、大肠息肉组、健康对照组血清H C M V-I g G阳性率为分别为95.0%(57/60)、98.3%(59/60)、96.7%(58/60);血清HCMV-Ig M阳性率分别为5.0%(3/60)、1.7%(1/60)、1.7%(1/60),3组血清H C M VIg G、Ig M差异无统计学意义(P0.05).32例大肠癌组织巢式PCR检测HCMV-UL138阳性率为65.6%(19/32),相应癌旁正常肠黏膜组织中为12.5%(4/32),原位杂交法检测癌组织HCMV-UL138阳性率为62.5%(20/32),癌旁正常肠黏膜组织中为9.4%(3/32),大肠癌组织HCMV阳性检出率较癌旁正常组织显著升高(P0.01).未发现HCMV感染与大肠癌患者的年龄、性别、肿块位置、肿块大小、组织病理分化类型、转移及Dukes分期有显著性关联.结论:大肠癌组织中存在HCMV感染,且H C M V相较于癌旁正常组织更倾向感染癌灶,提示HCMV感染可能参与大肠癌的发生发展过程.     

ELISA检测白血病和淋巴瘤患者弓形虫抗体阳性率

ELISA检测贵州省白血病和淋巴瘤患者各150例血样中弓形虫特异性抗体(Ig G、Ig M)和循环抗原(CAg),计算阳性率。PCR扩增弓形虫529 bp特异性片段。结果显示,白血病患者弓形虫Ig G和Ig M抗体阳性率分别为16.0%(24/150)和2.7%(4/150),CAg阳性率为2.0%(3/150)。淋巴瘤患者弓形虫Ig G和Ig M抗体阳性率分别为20.0%(30/150)和1.3%(2/150),CAg阳性率为0.7%(1/150)。健康人Ig G和Ig M抗体阳性率分别为6.4%(7/110)和0.9%(1/110),CAg阳性率为0.9%(1/110)。白血病患者、淋巴瘤患者和健康人之间弓形虫Ig G抗体阳性率差异有统计学意义(P0.05),白血病和淋巴瘤患者间Ig G抗体阳性率差异无统计学意义(P0.05);弓形虫Ig M抗体和CAg阳性率在各组间差异均无统计学意义(P0.05)。白血病患者、淋巴瘤患者和健康人血样中均未扩增出529 bp特异性条带。     

ELISA检测妇科肿瘤患者伴发弓形虫感染的调查

[目的 ]了解妇科宫颈癌患者伴发弓形虫感染的情况。[方法 ]采用 EL ISA法检测弓形虫 Ig G、Ig M抗体和循环抗原。 [结果 ]宫颈癌、妇科良性肿瘤、其它疾患妇女 3组人群的弓形虫感染率分别为 :44 .0 % (2 2 / 5 0 )、2 5 .4% (15 / 5 9)和 2 0 .3% (2 8/ 138)。 3组人群 Ig G阳性率分别为 2 0 .0 0 %、11.86 %和 10 .87% ,Ig M阳性率分别为2 0 .0 0 %、13.5 6 %和 8.70 % ,循环抗原阳性率分别为 14.0 0 %、5 .0 9%和 1.45 %。 [结论 ]宫颈癌患者弓形虫感染率明显高于其它两组人群 ,以循环抗原和 Ig M阳性尤为明显     

老年呼吸道感染患者肺炎衣原体、肺炎支原体感染情况分析

目的了解我院老年呼吸道感染患者肺炎衣原体(CP)和肺炎支原体(MP)感染状况,为临床诊断和治疗提供依据。方法采用胶体金法定性对263例老年呼吸道感染患者进行CP和MP及其血清抗体Ig G、Ig M检测。结果 263例老年呼吸道感染患者中,CP阳性52例,阳性率为19.8%;MP抗体阳性69例,阳性率为26.2%;MP阳性率略高于CP阳性率,但差异无统计学意义(P0.05)。CP和MP阳性患者共121例,阳性率为46.0%。在52例CP阳性患者中,CP-Ig G阳性33例,阳性率为63.5%;CP-Ig M阳性19例,阳性率为36.5%;CP-Ig G阳性率显著高于CP-Ig M阳性率,差异有统计学意义(P0.01)。在69例MP阳性患者中,MP-Ig G阳性43例,阳性率为62.9%;MP-Ig M阳性26例,阳性率为37.7%;MP-Ig G阳性率显著高于MP-Ig M阳性率,差异有统计学意义(P0.01)。结论老年呼吸道感染患者中CP抗体和MP抗体阳性率较高,CP、MP阳性患者的Ig G阳性率高于Ig M阳性率,对于老年呼吸道感染患者,在进行痰细菌培养检测的同时应进行肺炎衣原体、支原体Ig G、Ig M的检测,才能做到早发现、早诊断,对患者进行正确的治疗。     

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.     

Serological markers of Chlamydia pneumoniae infection in men and women and subsequent coronary events; the Scottish Heart Health Study Cohort.

AIMS: To investigate the relationship between serum markers of Chlamydia pneumoniae infection and subsequent coronary events. METHODS and RESULTS: In a nested case-control study, based on the Scottish Heart Health Study cohort, we estimated IgG, IgA and IgM antibodies to C. pneumoniae, and circulating immune complexes containing C. pneumoniae antigen in baseline serum samples from 217 cases experiencing a subsequent coronary event during follow-up (mean 7.5 years) and from their matched controls. In men, the proportion of specimens positive for IgG, IgA and IgM antibodies showed no case-control differences (80% vs 80%, 57% vs 53% and 3% vs 3%, respectively). The odds ratio for a coronary event was 1.00 (95% confidence interval 0.59-1.69) for the presence of IgG antibodies to C. pneumoniae; 1.21 (0.76-1.92) for IgA and 0.75 (0.17-3.35) for IgM. Similar results were seen in women. The proportion of specimens with circulating immune complexes with C. pneumoniae antigen also showed no case-control differences (12% vs 12%, both sexes combined) with an odds ratio of 1.00 (0.57-1.76). CONCLUSION: Prior infection with C. pneumoniae, as estimated by these markers, does not appear to be a risk factor for subsequent coronary heart disease.     

急性冠状动脉综合征患者巨细胞病毒检测及临床意义

目的：探讨人巨细胞病毒（ｈｕｍａｎ ｃｙｔｏｍｅｇａｌｏｖｉｒｕｓ,ＨＣＭＶ）感染与急性冠状动脉综合征（ａｃｕｔｅ ｃｏｒｏｎａｒｙ ｓｙｎｄｒｏｍｅ,ＡＣＳ）的关系。方法：利用人巨细胞病毒磷酸化蛋白ｐｐ７１基因引物,采用聚合酶链反应（ｐｏｌｙｍｅｒａｓｅ ｃｈａｉｎ ｒｅａｃｔｉｏｎ,ＰＣＲ）检测２２例急性冠状动脉综合征患者和３８例健康对照者外周血ＨＣＭＶ基因的表达。同时应用琼脂扩散法检测血清Ｉ     

The immune response to human cytomegalovirus-induced early nuclear and early membrane antigens and its possible clinical significance

Before replication of the human cytomegalovirus (HCMV) genome takes place, two major antigenic complexes are induced in the infected cell by an early expression of parental viral genome: one (Early antigen or EA) is localised in the nucleus, the other (Early membrane antigen or EMA) on the plasma-membrane. Sequential samples of serum from renal transplant recipients, pregnant women, blood donors and patients with known HCMV disease were examined by means of indirect immunofluorescence tests for the presence of IgG, IgM and IgA antibodies against EA and EMA. Serum antibody reacting with EMA belongs almost exclusively to the IgM class while that reacting with EA may be of the IgG, IgM or IgA class. IgM antibody to EMA seems to be preferentially associated with primary active HCMV infection.     

IgG, IgA, IgM antibodies to a viral citrullinated peptide in patients affected by rheumatoid arthritis, chronic arthritides and connective tissue disorders

OBJECTIVES: Anti-citrullinated protein/peptide antibodies (ACPA), a family of antibodies with overlapping specificities, represent a specific marker of rheumatoid arthritis (RA). The aim of the present study is to investigate the prevalence and clinical significance of IgG, IgA and IgM ACPA by a newly described assay employing a viral citrullinated peptide (VCP). METHODS: IgG, IgA and IgM anti-VCP antibodies have been measured in sera from 146 patients affected by RA and 404 controls, including 204 chronic arthritides, 111 connective tissue disorders and 89 healthy subjects. The affinity of the different isotypes for VCP was analysed by liquid phase inhibition assays. RESULTS: Among RA patients, 40 were single positive for IgG anti-VCP, five for IgA and 11 for IgM. Ten patients were double positive for IgG and IgA, four for IgG and IgM, six for IgA and IgM. In 15 RA patients IgG, IgA and IgM anti-VCP antibodies were detected. No correlation could be found between the isotype and the clinical manifestations or duration of the disease. IgA anti-VCP were strongly associated with RA, whereas IgM anti-VCP were detected also in a low percentage of systemic lupus erythematosus, psoriatic arthritis and mixed cryoglobulinaemia (MC) patients. IgG anti-VCP displayed a higher affinity for the antigen than IgA or IgM. CONCLUSIONS: These data show that anti-VCP of IgG and IgA isotype discriminate RA from other chronic arthritides and disease controls and suggest an independent production of each isotype.     

Chlamydia pneumoniae infection and atherosclerotic coronary disease.

BACKGROUND: Previous works have suggested an association between Chlamydia pneumoniae infection and coronary heart disease. We evaluated the prevalence of C. pneumoniae infection in patients with acute myocardial infarction (AMI) and coronary heart disease (CHD). METHODS AND RESULTS: Ninety-eight patients with AMI, 80 patients with CHD, and 50 control subjects matched for age and sex were investigated. Immunoglobulin (Ig)M, IgG, and IgA antibodies to C pneumoniae were measured by the microimmunofluorescence test. IgM antibodies were not found; IgG positivity was found in 58.2% of the AMI group, 60.0% of the CHD group, and 38% of the control group, whereas for IgA, positivity was found in 33.7%, 43.7%, and 22% of cases in AMI, CHD, and control groups, respectively. Titers indicating reinfection were found in AMI and CHD groups in 6.1% and 10%, respectively, whereas titers indicating chronic infection were found in 14% of the AMI group and 25% of the CHD group. A significant correlation was found between chronic C pneumoniae infection and dyslipidemias in the AMI and CHD groups (P =.003; P =. 0006). CONCLUSIONS: The results suggest that chronic C pneumoniae infection may be associated with the development of atherosclerotic coronary disease. In our next step, we will test whether antichlamydial antibiotics may help to reduce the risk of atherosclerotic disease.     

抗磷脂抗体与急性冠脉综合征相关性研究

目的：初步探讨抗磷脂抗体与急性冠脉综合征（ACS）的相关性。方法：应用酶联免疫吸附法检测55例ACS患者、23例稳定型心绞痛及陈旧性心肌梗死的患者和24例门诊体检人员血清中抗心磷脂抗体IgG,IgM亚型和抗p2糖蛋白I IgAGM,IgA,IgG,IgM亚型抗体的水平。结果：ACS组中抗磷脂抗体阳性率为54．3％,其中抗心磷脂抗体阳性率为17．5％,抗＆糖蛋白I抗体阳性率为36．8％。ACS组中抗心磷脂抗体IgG亚型、抗＆糖蛋白IIgAGM亚型及IgM亚型抗体的阳性率和滴度明显升高,尤其在急性心肌梗死患者中这3种抗体阳性率均显著高于对照组。另外,抗＆GPI抗体阳性的冠心病患者血脂水平（尤其是血清总甘油三酯）高于抗磷脂抗体阴性的冠心病患者血脂水平。结论：ACS的发病可能与抗磷脂抗体有关,尤以急性心肌梗死相关性明显,抗磷脂抗体可能参与ACS血管病变的发病过程。     

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.     

Relationship between Chlamydia pneumoniae and classical risk factors of coronary heart disease

In order to elucidate relationship between Chlamydia pneumonia infection and established risk factors of coronary heart disease (hypercholesterolemia, hyperglycemia, hyperfibrinogenemia, smoking, age) chlamydial IgA and IgG antibodies were determined by solid phase enzyme immunoassay in 122 patients with ischemic heart disease and 40 healthy subjects. Elevated titers of IgA class antibodies were found to be associated with presence of ischemic heart disease as well as with hypercholesterolemia, hyperglycemia, hyperfibrinogenemia, and smoking.