人巨细胞病毒感染作为冠心病独立危险因子的可能性探讨

背景目前对人巨细胞病毒( human cytomegalovirus, HCMV)感染与冠心病的关系及 HCMV感染可否作为冠心病的独立危险因子还存在争议.目的进一步探讨 HCMV感染与冠心病的关系及 HCMV感染可否作为冠心病的独立危险因子.设计单盲非随机的对照试验.地点、对象和方法选择广东医学院附属医院和第二附属医院住院患者 98例为冠心病组 (年龄 42～ 72岁 ),广东医学院健康志愿者 50例为对照组 (年龄 40～ 69岁 ,已经临床及实验室检查排除了心脏疾患 ),采用间接酶联免疫吸附测定( ELISA)检测两组的 HCMV-IgG, HCMV-IgM和 HCMV-IgA抗体阳性率和标本 450 nm吸光度值 /阴性对照 450 nm吸光度值( S/N值),聚合酶链反应( PCR)检测两组的 HCMV-DNA阳性率.主要观察指标两组患者 HCMV-IgG, HCMV-IgM和 HCMV-IgA抗体阳性率、 S/N值和 HCMV-DNA阳性率比较.结果冠心病组的 HCMV-IgG, HCMV-IgM, HCMV-IgA抗体阳性率分别为 91.8%, 15.3%和 16.3%,均明显高于对照组 (P《 0.01);冠心病组的 S/N值分别为 3.57± 1.29, 1.98± 0.35和 1.99± 0.31,均明显高于对照组 (P《 0.01); HCMV-DNA阳性率为 60.2%,明显高于对照组 (P《 0.01).HCMV抗体和 HCMV-DNA阳性率不受血清胆固醇、三酰甘油水平及是否伴有高血压和 /或糖尿病的影响(除 HCMV-IgM抗体阳性率在是否伴有高血压和 /或糖尿病两组间比较 P《 0.05外 ,余均为 P 》0.05).结论 HCMV感染可能与冠心病有关, HCMV感染可能可作为冠心病的独立危险因子.

Human cytomegalovirus infection:an independent risk factor of coronary heart disease

BACKGROUND:The relationship between human cytomegalovirus(HCMV) infection and coronary heart disease(CHD) has currently remained controversial and the question whether HCMV infection should be an independent risk factor of CHD has not been answered. OBJECTIVE:To further understand the relationship between HCMV infection and CHD,and assess the possibility of HCMV infection as an independent risk factor of CHD. DESIGN:Examiner-blinded non-randomized controlled trial. SETTING,PARTICIPANTS and METHODS:Ninety-eight CHD patients aged from 42 to 72 years were recruited from the Affiliated Hospital and the Second Affiliated Hospital of Guangdong Medical College,and 50 healthy volunteers from Guangdong Medical College aged between 40 to 69 years(who were free of cardiopathy as defined by clinical and laboratory examinations) were included as the control group. Indirect enzyme-linked immunoadsorbent assay(ELISA) was employed to determine the positive rates and the ratios of sample absorbance at 450 nm to that of negative control(S/N ratio) of HCMV-IgG,IgM,and IgA antibodies.Polymerase chain reaction(PCR) technique was used to measure the positive rates of HCMV DNA. MAIN OUTCOME MEASURES:The positive rates and S/N ratios of HCMV-IgG,IgM,and IgA antibodies as well as the positive rates of HCMV DNA were compared between the two groups. RESULTS:The positive rates of HCMV-IgG,IgM,and IgA antibodies in CHD group were 91.8% ,15.3% ,and 16.3% ,respectively,which were much higher than those in the control group(P< 0.01).The S/N ratios of HCMV-IgG,IgM,and IgA antibodies in CHD group were(3.57± 1.29),(1.98± 0.35),and(1.99± 0.31),respectively, also much higher than those in control group(P< 0.01).The positive rate of HCMV DNA was 60.2% in the CHD group,significantly higher than that in the control group(P< 0.01).The positive rates of HCMV antibodies and DNA were not be affected by cholesterol or triglyceride levels,nor by hypertension with or without diabetes mellitus(P >0.05),but the positive rate of HCMV IgM was significantly different between diabetic and non-diabetic hypertensive patients(P< 0.05). CONCLUSION:HCMV infection may be related to CHD and can be considered as a possible independent risk factor of CHD.