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目的探讨肺炎衣原体(CPn)感染与动脉血栓性脑梗塞的关系。方法用酶联免疫吸附试验(ELISA)法测定脑血管病患者共246例:其中脑梗塞患者112例,脑出血106例,均经头颅CT或MRI检查证实;TIA患者28例。50例其他疾病患者的血清肺炎衣原体特异性IgG抗体及IgM抗体。结果肺炎衣原体慢性感染率分别为脑梗塞组85.71%(96/112)和对照组48%(24/50),脑梗塞患者肺炎衣原体慢性感染率均明显高于对照组,脑血管病组(包括脑梗塞及脑出血)肺炎衣原体慢性感染率为80.4%,明显高于对照组有统计学差异(P<0.01)。肺炎衣原体IgG阳性病例血清TG浓度明显高于肺炎衣原体IgG阴性的病例(P<0.05);HDL-C则明显低于阴性组。以克拉霉素治疗清除肺炎衣原体感染,观察其12月、18月、24月脑血管事件的发生率,表明其再发生率明显下降。结论脑梗塞患者肺炎衣原体感染率明显增高,提示肺炎衣原体感染可能与脑梗塞有关。其可能的机理是肺炎衣原体感染后形成免疫复合物沉积在血管壁,引起血管局部损伤;以及改变了血脂浓度来增加脑血管病发生的危险性。克拉霉素治疗清除肺炎衣原体感染对动脉血栓性脑梗塞有一定的预防作用。
Objective To investigate the relationship between Chlamydia pneumoniae (CPn) infection and arterial thrombotic cerebral infarction. Methods A total of 246 patients with cerebrovascular disease were detected by enzyme-linked immunosorbent assay (ELISA) method: 112 patients with cerebral infarction and 106 patients with cerebral hemorrhage were confirmed by CT or MRI; 28 patients with TIA. Serum C. pneumoniae-specific IgG antibodies and IgM antibodies in 50 patients with other diseases. Results Chlamydia pneumoniae infection rate was 85.71% (96/112) in cerebral infarction group and 48% (24/50) in control group respectively. Chronic infection rate of Chlamydia pneumoniae in patients with cerebral infarction were significantly higher than those in control group, cerebrovascular disease group Cerebral infarction and intracerebral hemorrhage) Chlamydia pneumoniae chronic infection rate was 80.4%, significantly higher than the control group was statistically significant (P <0.01). Serum TG concentration of Chlamydia pneumoniae IgG positive cases was significantly higher than that of Chlamydia pneumoniae IgG negative cases (P <0.05); HDL-C was significantly lower than negative group. Chlamydia pneumoniae infection was treated with clarithromycin, and the incidence of cerebrovascular events in December, 18 and 24 months was observed, which showed that the recurrence rate was significantly decreased. Conclusion The infection rate of Chlamydia pneumoniae in patients with cerebral infarction was significantly higher, suggesting that Chlamydia pneumoniae infection may be related to cerebral infarction. The possible mechanism is the formation of immune complexes of Chlamydia pneumoniae after the deposition of the deposition of the complex in the vessel wall, causing local vascular damage; and changed the concentration of lipids to increase the risk of cerebrovascular disease. Clarithromycin treatment of Chlamydia pneumoniae infection on arterial thrombotic cerebral infarction have a preventive effect.