冠心病外周血单核细胞肺炎衣原体包涵体的检测

本文探讨冠心病患者外周血单核细胞（PBMC）中肺炎衣原体（Cpn）包涵体检测的临床应用价值。作者选择150例冠心痛（冠心痛组）及55例非冠心痛（对照组）患者，使用低渗溶血法制备PBMC，直接免疫荧光法检测Cpn包涵体。结果表明，Cpn包涵体阳性反映患者体内存在Cpn感染状态。     

阿奇霉素联合头孢曲松治疗社区获得性肺炎

[目的]探讨阿奇霉素联合头孢曲松治疗社区获得性肺炎(CAP)的疗效及其它影响。[方法]300例CAP患者随机分成AC组和CE组各150例,每组中伴有肺炎衣原体(Cpn)感染16例。AC组给予阿齐霉素和头孢曲松钠治疗,CE给予头孢曲松钠治疗。用微量免疫荧光法检测抗Cpn抗体效价,胶体金法(DIGFA)快速定量测定C-反应蛋白(CRP)。[结果]治疗后AC组Cpn-IgM抗体滴度下降(P0.05)、Cpn-IgM阳性率下降(P=0.051);两组CRP均下降;AC与CE组总有效率类似(分别为98.0%和95.3%);细菌总清除率也类似(分别为88.1%和86.8%)。[结论]AC与CE组治疗CAP都有良好疗效,阿奇霉素对伴有Cpn急性感染者疗效较好。     

肺炎衣原体感染与急性心肌梗死、超敏C反应蛋白、细胞间黏附分子-1、白细胞介素-6的相关性研究

目的探讨肺炎衣原体（Cpn）感染与冠心病心肌梗死及其有关炎症介质的关系。方法分别采用酶联免疫吸附试验（ELISA）法和聚合酶链反应（PCR）测定51例急性心肌梗死、42例陈旧性心肌梗死患者及冠脉造影正常的31例正常对照者、33例非冠心病患者血Cpn抗体水平及DNA，同时检测各组的超敏C反应蛋白（hsCRP）、可溶性细胞间黏附分子（sICAM）-1、白细胞介素（IL）-6的变化。结果急性心肌梗死组Cpn IgG，Cpn IgM阳性率及水平高于正常对照组、非冠心病组，Cpn DNA检测结果与之一致。校正冠心病危险因素前、后，Cpn IgG阳性与急性心肌梗死均有相关性（分别0R=3．653，P=0．025；OR=3．174，P=0．033）。急性心肌梗死组治疗前分别与其余组比较，hsCRP，sICAM-1、IL-6均显著升高（均P〈0．01）；陈旧性心肌梗死组分别与非冠心病组、正常对照组比较，slCAM-1，IL-6显著升高（均P〈0．01），而hsCRP升高不显著。心肌梗死各组中Cpn（＋）组与同组Cpn（-）组比较，hsCRP，sICAM-1，IL-6均显著升高（P〈0．01或P〈0．05）；IgG与hsCRP，sICAM-1，IL-6呈正相关。结论Cpn感染与急性心肌梗死存在明显相关性，与hsCRP，sICAM-1，IL-6也存在相关性。     

肺炎衣原体感染对老年冠心病患者疾病进展影响的研究

目的探讨肺炎衣原体感染对老年冠心病患者的影响因素,为临床治疗提供参考依据。方法选取2011年4月-2013年6月肺炎衣原体感染的老年冠心病患者81例和未合并肺炎衣原体感染的老年冠心病患者82例分别作为A、B两组,测定内皮素-1(ET-1)、白介素-6(IL-6)、C反应蛋白(CRP)、纤维蛋白原(Fg)、可溶性血管细胞黏附因子-1(sVCAM-1)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(CTnⅠ)水平并进行比较,采用SPSS13.0进行统计分析;将A组患者均给予阿奇霉素口服,对该组患者治疗前后CP-IgA和IgG水平进行测定。结果 A组患者ET-1、IL-6、CRP、Fg、sVCAM-1、CK、CK-MB、CTnⅠ水平分别为(51.23±20.54)pg/ml、(10.61±12.46)ng/L、(1.54±2.72)mg/L、(2.98±0.84)g/L、(27.33±25.78)IU/L、(159.67±87.36)IU/L、(17.05±10.32)IU/L、(0.16±0.08)ng/ml均明显高于B组,两组比较,差异有统计学意义(P<0.05);经过治疗A组患者CP-IgA和IgG阳性率分别为32.10%、27.16%,治疗前的69.14%、53.09%明显降低,差异有统计学意义(P<0.05)。结论肺炎衣原体感染与老年冠心病有着密切的关系,病原体感染所致的炎症因子升高可促进动脉粥样硬化的病程进展,从而增加患者发生心梗等心血管事件的概率;通过阿奇霉素治疗,可以有效治疗肺炎衣原体感染,有利于稳定患者病情。     

衣原体及不同病毒感染与冠心病的关系

目的了解肺炎衣原体(Cpn)、巨细胞病毒(HCMV)、甲型肝炎病毒(HAV)感染和冠心病(CHD)之间的关系以及各感染因子之间的相互联系.方法应用酶联免疫吸附试验分别检测冠心病患者90例和对照组90例血清Cpn特异性IgG抗体、血清HCMV特异性IgG抗体和血清HAV特异性IgG抗体.结果病例组中血清Cpn IgG和HCMV IgG抗体阳性率分别为55.6%和71.1%,对照组分别为30.0%和45.6%,有显著性差异;而HAV IgG抗体阳性率在CHD组中为81.1%,对照组为75.6%,无显著性差异.交互作用分析表明,Cpn和CMV感染可协同促进冠心病的发生,其效应指数为5.80.结论Cpn和HCMV感染与冠心病之间有一定的统计学联系,且两种感染因子在冠心病的发病中存在正交互作用,HAV感染与冠心病之间无明显相关性.     

肺炎衣原体感染与急性冠脉综合征的关系

目的探讨肺炎衣原体感染与急性冠脉综合征发生发展的关系. 方法通过测定外周血中肺炎衣原体抗体IgG的水平,确定有无感染,用流式细胞仪测定外周血中HLA-DR以及PAC-1表达水平,以明确机体炎性细胞以及血小板激活的情况. 结果急性冠脉综合征患者中,肺炎衣原体感染者HLA-DR的阳性率(65.66±23.34)%显著低于未感染者(83.91±15.37)%,P=0.001; 急性冠脉综合征与非急性冠脉综合征患者PAC-1的阳性率差别有显著性(1.95±3.29)% vs(0.63±0.73)%,P=0.035; 急性冠脉综合征患者中肺炎衣原体感染者PAC-1的阳性率显著高于非感染者(2.59±3.99)% vs(1.33±2.33)%, P=0.005; 急性冠脉综合征与非急性冠脉综合征患者肺炎衣原体感染的比例没有差异. 结论肺炎衣原体感染的急性冠脉综合征患者,不论是在体内抗炎机制的过度激活,还是在血小板的活化方面都强于其他组,说明肺炎衣原体感染在冠心病的发生发展上可能有比较重要的作用.     

肺炎衣原体感染与急性心肌梗死、血栓素B2、6-酮-前列环素F1α、P-选择素的关系

目的探讨肺炎衣原体(Cpn)感染与冠心病心肌梗死的关系.方法测定51例急性心肌梗死(AMI)和42例陈旧性心肌梗死(OMI)患者及31例冠脉造影正常者(NC)血Cpn抗体水平及DNA,同时观测6-酮-前列环素F1α(6-Keto-PGF1α)、血栓素B2(TXB2)、P-选择素(GMP140)变化及其与Cpn感染的相关性.结果 AMI组CpnIgG、CpnIgM阳性率及水平高于NC组(P<0.05),CpnDNA检测结果与之吻合.校正冠心病危险因素前、后,CpnIgG阳性与AMI均有相关关系(OR 3.653,P=0.025;OR 3.174,P=0.033).AMI组中Cpn(+)组TXB2、GMP140高于Cpn(-)组,而6-Keto-PGF1α低于Cpn(-)组(P均＜0.05)及NC、OMI组中Cpn(+)组(P均＜0.01);且IgG与TXB2、GMP140呈正相关,与6-Keto-PGF1α呈负相关.结论 Cpn感染与AMI之间存在明显的相关性,与TXB2、6-Keto-PGF1α及GMP140也存在相关性.     

阿奇霉素在小儿呼吸道肺炎支原体感染治疗中的疗效观察

目的了解阿奇霉素治疗小儿呼吸道肺炎支原体感染的疗效。方法对2198例住院呼吸道感染疾病婴儿采用FQ-PCR技术检测疾液MP-DNA和胶体金标记免疫法检测血清MP-IgM,两者阳性诊断为肺炎支原体感染,共254例,均予阿奇霉素进行治疗。结果205例(80.71%)静脉滴注阿奇霉素1个疗程(5天)症状明显缓解,继续口服阿奇霉素1个疗程(3天)症状消失;49例(19.29%)静脉滴注阿奇霉素2个疗程(10天)症状明显缓解,继续口服阿奇霉素1个疗程(3天)症状消失。结论阿奇霉素对小儿呼吸道肺炎支原体感染疗效确切。     

阿奇霉素对肺炎衣原体感染及冠心病二级预防的临床研究

目的探讨阿奇霉素长期小剂量应用对冠心病二级预防的作用.方法选择符合冠心病诊断标准的180例患者,其中无症状型冠心病75例,不稳定型心绞痛53例,急性心肌梗死52例,采用随机双盲安慰剂对照的方法,按随机数字表分为阿奇霉素治疗组及安慰剂对照组,两组药物的药品包装名均为阿奇霉素.结果180例患者中89例纳入阿奇霉素组,随访1年,13例出现冠心事件,发生率14.6%,安慰剂组91例27例出现冠心事件,发生率29.7%,阿奇霉素组冠心事件发生率低于安慰剂组,减少了15.1%,OR 0.405, 95%的CI 0.193～0.85;阿奇霉素组有4例因出现上腹痛、恶心退出研究,3例出现腹胀、恶心但程度轻,能耐受,副作用发生率为7.9%,安慰剂组有6例出现腹胀,2例不能耐受, 退出研究,副作用发生率为6.6%,两组间差异无显著性;两组治疗前后IgG抗体滴度及各组治疗后抗体滴度的差值比较差异无显著性.结论研究结果表明阿奇霉素能减少冠心病的症状发生,对冠心病二级预防有一定疗效,长期小剂量应用安全、耐受性好,但随访治疗前后及治疗后IgG抗体滴度无变化.     

慢性咳嗽患儿肺炎支原体、肺炎衣原体IgM抗体测定分析

目的 探讨慢性咳嗽患儿肺炎支原体(Mp)、肺炎衣原体(Cpn)IgM抗体情况.方法 对确诊的68例慢性咳嗽患儿(慢性咳嗽组)和60例无咳嗽症状的健康体检儿童(对照组)采用ELISA法检测血浆Mp、Cpn IgM抗体,并进行组问比较.结果 慢性咳嗽组与对照组Mp IgM抗体阳性分别是27例(39.7%)、3例(5.0%);Cpn IgM抗体阳性分别是12例(17.6%)、1例(1.7%),两组比较差异均有统计学意义.结论 Mp、Cpn感染与小儿慢性咳嗽关系密切,临床应采用针对性治疗.     

冠心病患者肺炎衣原体感染的研究

目的：研究冠心病与肺炎衣原体感染的关系。方法：应用微量免疫荧光试验，检测冠心病患者血清中肺炎衣原体IgG、IgA抗体，并与病毒性心肌炎和对照组比较。结果：214例冠心病患者肺炎衣原体IgG、IgA抗体阳性率分别为86．9％和39．7％，显著高于病毒性心肌炎组（分别为62．7％和8．2％）和对照组（分别为72．6％和13．7％），冠心病患者IgG、IgA抗体阳性率与其他两组抗体阳性率差异显著（P＜0．010。此外，冠心病患者IgG、IgA抗体几何平均滴度亦明显高于病毒性心肌炎组患者和对照组。结论：冠心病与肺炎衣原体感染存在一定的关系。     

Identification of new potential vaccine candidates against Chlamydia pneumoniae by multiple screenings

Chlamydia are intracellular bacteria associated to serious human disease. A vaccine has proved difficult to obtain so far, and current opinions agree that multi-antigen combinations may be required to induce optimal protective responses. In order to identify new potential vaccine candidates, we recently screened the Chlamydia pneumoniae (Cpn) genome and described 53 recombinant proteins which elicited antibodies binding to purified Cpn cells. We now report that six proteins in this group can also induce in vitro neutralizing antibodies. Antibody specificity for the corresponding antigens was assessed by immunoblot analysis of 2DE Cpn protein maps. Furthermore, four of the six in vitro neutralizing antigens (Pmp2, Pmp10, OmpH-like and enolase) could inhibit Cpn dissemination in a hamster model. The results show that these Cpn proteins are immunoaccessible in infectious EBs, and recommend further investigation on their value as vaccine components.     

套式聚合酶链反应法检测外周血单个核细胞中HBcVccDNA

目的:建立套式聚合酶链反应法(nPCR)检测慢性乙型肝炎患者外周血单个核细胞(PBMC)中乙型肝炎病毒共价闭合环状DNA(HBV cccDNA)。方法:根据HBV基因组DNA正负链上下游缺口序列,设计两套相对保守的引物,建立HBV cccDNA套式PCR,并用该法检测200例慢性乙型肝炎患者PBMC中HBV cccDNA。结果:该法检测200例慢性乙型肝炎患者,HBV cccDNA阳性率为60%。结论:套式PCR法简便、灵敏,可用于测定PBMC中HBV cccDNA。     

扬州市性传播疾病患者支原体、衣原体、淋病奈瑟菌及阴道加特纳菌感染情况的研究

目的 研究扬州市男性性传播疾病(STD)患者支原体、衣原体、淋病奈瑟菌及阴道加特纳菌的感染情况。方法 收集男性STD患者病灶拭子标本进行解脲脲原体(Uu)、人型支原体(Mh)、肺炎支原体(Mpn)、生殖支原体(Mg)、发酵支原体(Mf)、穿通支原体(Mpe)、梨支原体(Mpi)、沙眼衣原体(Ct)、肺炎衣原体(Cpn)、鹦鹉热衣原体(Cps)、淋病奈瑟菌(Ng)和阴道加特纳菌(GV)等12种病原体作巢式聚合酶链反应(nPCR)检测,并对Ng阳性者进行了产青霉素酶淋病奈瑟菌(PPNG)检测。结果 Un、Mh、Mpn和Mg 4种支原体阳性率分别为64.5％、27.6％、26.3％、18.4％,Mf和Mpe为2.6％,Mpi未检出;Ct为31.6％,Cpn和Cps无阳性病例检出;Ng为36.8％,其中PPNG占14.3％;GV阳性率为15.8％。淋球菌阳性的男性STD者与淋球菌阴性者中支原体核酸检出率差异有显著性(X~2=3.848,P<0.05)。结论 扬州市男性STD患者支原体、衣原体、淋病奈瑟菌、阴道加特纳菌感染率较高。在临床诊疗中应重视淋球菌、衣原体、支原体和阴道加特纳菌的检测,使患者能获得正确诊断与合理治疗。     

Infection with Chlamydia pneumoniae and risk of multiple sclerosis

BACKGROUND: Chlamydia pneumoniae (Cpn) has been proposed as a possible etiologic agent for multiple sclerosis (MS), but results of previous studies are conflicting. METHODS: Using a nested case-control design, we examined the association between Cpn infection and MS in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHS II) cohorts. Among 32,826 women in the NHS and 29,722 women in the NHS II with blood samples, 141 incident cases of definite or probable MS were documented. Each case was matched to two healthy controls on year of birth and NHS cohort. Serum samples were tested for the presence of Cpn-specific immunoglobin G antibodies using microimmunofluorescence. RESULTS: Cpn immunoglobin G seropositivity was positively associated with risk of MS (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.1-2.7). This association did not change after adjusting for age at blood collection, ancestry, latitude of residence at birth, and smoking (OR = 1.9; CI = 1.1-3.1). Seropositivity for Cpn was only moderately associated with risk of relapsing-remitting MS (OR = 1.7; CI = 0.9-3.2), but it was strongly associated with risk of progressive MS (OR = 7.3; CI = 1.4-37.2). Geometric mean titers of Cpn-specific immunoglobin G antibody were similar in women with relapsing-remitting MS as compared with matched controls (44 vs 39), but they were elevated in women with progressive MS (99 vs 40). CONCLUSIONS: These results support a positive association between Cpn infection and progressive MS.     

Chlamydia pneumoniae infection and incident coronary heart disease: the Atherosclerosis Risk in Communities Study.

Pathologic findings and cross-sectional epidemiologic studies suggest that past infection with Chlamydia pneumoniae is associated with clinical and subclinical atherosclerotic disease, although evidence from prospective studies is still scarce. The association between chronic infection by C. pneumoniae and incident coronary heart disease (CHD) was investigated in a case-cohort study conducted among participants in the Atherosclerosis Risk in Communities Study who were free of CHD at the baseline examination (1986-1989). Levels of C. pneumoniae immunoglobulin G (IgG) antibodies in serum collected at baseline from 246 incident cases of CHD identified during follow-up (median, 3.3 years; maximum, 5 years) were compared with those from a stratified sample of the baseline cohort (n = 550). Among incident CHD cases, 65% had IgG antibody titers > or =1:64, compared with 55% of noncases (compared with negative IgG titers, the relative hazard of CHD was 1.6 (p < 0.01)). In multivariate analyses controlling for other risk factors (age, gender, smoking, serum cholesterol, hypertension, diabetes mellitus, and educational level), the above estimates were substantially reduced and became statistically nonsignificant (relative hazard = 1.2). A significantly increased CHD hazard associated with IgG antibody titers > or =1:64 was observed among nonsmokers, even after adjustment for other risk factors. Overall, these results do not provide strong support for the hypothesis that C. pneumoniae infection is a risk factor for clinical CHD. Studies with longer follow-up periods will be necessary to determine whether C. pneumoniae infection is involved as an etiologic factor in earlier phases of atherogenesis.     

阿奇霉素对肺炎支原体肺炎患儿血清白细胞介素8和10的影响

目的:观察肺炎支原体(MP)肺炎患儿血清白胞介素8(IL-8)和白细胞介素10(IL-10)的变化及阿奇霉素治疗对其的影响。方法:以2007年1月~2010年5月连续收治的MP肺炎患儿56例为研究对象(MP组),给予阿奇霉素治疗,疗程7天;同时选择同期的健康儿童50例为正常对照组。用ELISA法检测两组治疗前后血清IL-8和IL-10水平的变化,观察阿奇霉素治疗MP肺炎的临床疗效。结果:阿奇霉素治疗MP肺炎总有效率为96.4%。与正常对照组比较,MP组治疗前血清IL-8水平显著升高,IL-10水平明显下降(均P<0.05);阿奇霉素治疗后,MP组患儿血清IL-8水平下降,IL-10水平升高,接近正常对照组(均P<0.05)。结论:阿奇霉素可降低肺炎支原体肺炎患儿血清IL-8水平,提高IL-10的水平。