肺炎衣原体感染与原发性胆汁性肝硬化的相关性研究

目的 通过检测原发性胆汁性肝硬化(PBC)患者血清中抗肺炎衣原体(CP)IgG、IgM水平,探讨CP感染与PBC之间的相关性。 方法 采用CP酶联免疫固相吸附试验检测41例PBC患者(PBC组)、70例肝炎后肝硬化(疾病对照组,PHC组)和57名健康查体者(正常对照组)血清抗CP IgG、IgM抗体水平。 结果 PBC组和PHC组的抗CP IgG平均水平(RU/ml)较正常对照组高(46.8±43.4、49.5±45.2与28.3±32.7,P=0.042与P<0.001),但PBC组与PHC组之间差异无显著性(P=O.059);PBC组、PHC组抗CP IgG阳性率亦高于正常对照组(68.3％、71.4％与42.1％,x2值分别为5.389、11.110,P值均小于0.05),PBC组与PHC组差别无显著性(x2=0.378,P>0.05);PBC组患者的血清抗CP IgM阳性率最高(22.0％),明显高于其它两组。与正常对照组比较,PBC组抗CP IgG、IgM阳性的比率比(OR)分别为2.7(95％ CI:0.9～6.1)、5.1(95％ CI:1.4～18.5);血清抗CP IgG水平与总IgG浓度无相关性(r=-0.857,P=0.344),而抗CP IgM阳性与总IgM异常升高有关。 结论 血清学研究结果尚不能支持肺炎衣原体是PBC的一个始动因素这一观点,但CP感染可能是造成PBC中IgM升高的原因之一。

The relationship between Chlamydia pneumoniae infection and primary biliary cirrhosis

OBJECTIVE: The aim of this study was to evaluate the association between Chlamydia pneumoniae (CP) infection and primary biliary cirrhosis (PBC). METHODS: Chlamydia pneumoniae IgG and IgM were determined by enzyme-linked immunosorbent assay (ELISA) in 41 well-established PBC patients and two race-matched control groups, PHC, n = 70; healthy controls, HC, n =57). RESULTS: The mean levels and seroprevalence of CP IgG in PBC group and PHC group were significantly higher than in the HC [(46.8 +/- 43.4) RU/ml, (49.5 +/- 45.2) RU/ml vs (28.3 +/- 32.7) RU/ml, P = 0.042 and P < 0.001 respectively; 68.3%, 71.4% vs 42.1%, chi2 values were 5.389 and 11.110 respectively]. There was a markedly elevated seroprevalence of CP IgM in patients with PBC (22.0%) compared with the PHC and HC groups. The odds ratios (ORs) for the presence of CP IgG and IgM for the PBC patients versus the HC were 2.7 (95% CI 0.9 to 6.1) and 5.1 (95% CI 1.4 to 18.5). Though there was no correlation in the level of CP IgG with total IgG in sera of patients with PBC (r=-0.857, p=0.344), CP IgM was related with the abnormally high concentrations of total IgM in the PBC group. CONCLUSIONS: The results of this study do not support the hypothesis that infection with Chlamydia pneumoniae may be a triggering agent for PBC, but suggest that Chlamydia pneumoniae infection probably contributes to the high level of IgM presented in most of the patients with PBC