肺炎衣原体感染与卒中关系的研究

目的:探讨肺炎衣原体(Chlamydia pneumonia,Cpn)感染与卒中的关系。方法:用酶联免疫吸附法(ELESA)测定卒中患者(研究组)120例和健康体检者(对照组)60例血清中Cpn抗体(IgM、IgA、IgG),同时测定其血清总胆固醇(cholesterol,TC)、三酰甘油(triacylglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)水平。根据卒中的发病机制和影像学检查将研究组分为4个亚组:脑血栓形成组(48例)、短暂性脑缺血发作(transient ische-mic attack,TIA)组(14例)、心源性脑栓塞组(29例)、脑出血组(29例)。分析Cpn-IgM、Cpn-IgA、Cpn-IgG与卒中各亚组的相关性以及Cpn-IgA与血脂的关系。结果:研究组和对照组的性别、年龄、糖尿病史、吸烟史、高血压史差异均无统计学意义,两组间的TC、TG、LDL、HDL水平有显著差异(P<0.05);研究组各亚组中Cpn-IgA、Cpn-IgG阳性与脑血栓形成、TIA呈独立相关,与心源性脑栓塞、脑出血无显著相关;Cpn-IgA阳性组(124例)与阴性组(56例)的TC、TG、LDL差异有统计学意义(P<0.001)。结论:Cpn慢性反复感染可能是动脉粥样硬化性脑血管病的独立危险因素,其致病机制可能与血脂代谢异常有关。

Chlamydia Pneumonia Infection in Stroke Patients

Objective：To investigate the infection of Chlamydia pneumonia（Cpn） in stroke patients and its relationship with risk factors of stroke.Methods：In this case-control study,120 patients with stroke and 60 healthy controls were tested serologically for specific Cpn-IgM,Cpn-IgA and Cpn-IgG by enzyme-linked immunoadsorbent assay（ELESA）.Moreover,cholesterol（TC）,triacylglyceride（TG）,high density lipoprotein（HDL） and low density lipoprotein（LDL） were also detected.According to pathogenesis and imaging findings of stroke,120 cases were divided into four groups： cerebral infarction group（n=48）,transient ischemic attack（TIA） group（n=14）,cerebral cardioembolism group（n=29） and hematencephalon group（n=29）.Results： There were significant differences between cases and controls in TC,TG,HDL,LDL,Cpn-IgA and Cpn-IgG seropositivity.Logistic stepwise regression analysis showed that Cpn-IgA and Cpn-IgG seropositivity were independently associated with atherosclerosis stroke（including cerebral infarction and TIA）,but not with cardioembolic or hematencephalon subtypes.180 people in this study were divided into Cpn-IgA seropositivity group（n=124） and Cpn-IgA seronegativity group（n=56）.The levels of serum TC,TG,LDL in Cpn-IgA seropositivity group were significantly higher than those in Cpn-IgA seronegativity group.Conclusions： Serologic positivity of Cpn-IgA and Cpn-IgG is independently related to atherosclerosis stroke.The mechanism is likely to be associated with dyslipidemia.