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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)的Cpn抗体(CpnIgG、CpnIgM)水平及DAN,同时观测C反应蛋白(CRP)、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)]变化。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CRP、TC、TG、LDLC高于同组中Cpn(-)组(均P<0.05),且IgG与CRP、TC、LDLC呈正相关(P<0.05),调整与CRP相关的冠心病危险因素后,IgG与CRP仍呈正相关;OMI组中Cpn(+)组TG明显高于Cpn(-)组(P<0.05),IgG与TG呈正相关。结论Cpn感染与AMI之间存在明显的相关性,与血脂、CRP也存在相关性。
Objective To investigate the relationship between Chlamydia pneumoniae (Cpn) infection and myocardial infarction in patients with coronary heart disease. Methods Cpn antibody (CpnIgG, CpnIgM) and DAN in 51 patients with acute myocardial infarction (AMI) and 42 patients with old myocardial infarction (OMI) and 31 patients with coronary artery disease (NC) were measured and their levels of C-reactive protein CRP, TC, TG, LDLC, HDLC) were measured. Results The positive rate and the level of CpnIgG and CpnIgM in AMI group were higher than those in NC group (P <0.05). The results of CpnDNA test were consistent with those in NC group. Correlation of CpnIgG positivity with AMI before and after the correction of risk factors for coronary heart disease (OR = 3.653, P = 0.025; OR = 3.174, P = 0.033). The levels of CRP, TC, TG and LDLC in Cpn (+) group were higher than those in Cpn (-) group in AMI group (all P <0.05), and there was a positive correlation between IgG and CRP, TC and LDLC There was a positive correlation between IgG and CRP after CRP-related risk of coronary heart disease. The TG of Cpn (+) group in OMI group was significantly higher than that of Cpn (-) group (P <0.05). IgG was positively correlated with TG. Conclusions There is a significant correlation between Cpn infection and AMI, and there is also a correlation between blood lipids and CRP.