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。

Significance and mechanism of human cytomegalovirus infection in coronary atherosclerotic heart disease

Objective：To study the significance of the human cytomegalovirus (HCMV) infection in the etiology of coronary atherosclerotic heart disease (CHD) and the possible mechanism of acute inflammation in CHD. To provide easy and practical detecting methods for early diagnosis of CHD.Method:HCMV-IgM,IgG and CRP were detected in 80 patients with CHD and 26 patients without CHD. The CHD group was divided into acute coronary syndromes group (group A，n=59) and stable symptom group (group B，n=21).Result:The positive rate of HCMV-IgM, IgG and the levels of CRP were higher in CHD group than those in control group(P<0.05), especially in group A(P<0.01). There were no difference of the above indexes between group B and the control group (P>0.05).The levels of CRP were higher in patients with AMI than in those with unstable angina (P<0.05). There was close relationship between the HCMV-IgM and CRP in acute coronary syndromes group (r=0.336).Conclusion:The infection and activation of HCMV are significant in the etiology of CHD, especially in patients with acute coronary syndromes. It′s mechanism may be related to the acute inflammation. HCMV-IgM and CRP can be helpful in the early diagnosis of acute coronary syndromes. Quantitative detection of CRP can evaluate the progress of CHD.