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目的:探讨血清肺炎衣原体IgA,IgG抗体水平与原发性高血压的关系。方法:①于1999-07/2001-12从北票市在册的500名中小学教师中选取原发性高血压患者56例为患者组,男26例,女30例;从该人群中随机抽取年龄、性别与病例组相匹配的健康者35人为对照组,男17人,女为18人。纳入对象均知情同意。②在对象入组时完成自拟调查表(内容包括:一般特征、吸烟史、饮酒史、高血压家族史等)的一般性调查;同时测量血压、身高、体质量等。③血清肺炎衣原体IgA,IgG抗体的测定采用酶联免疫试验试剂盒。标本的肺炎衣原体抗体水平用酶联免疫单位表示。IgA抗体酶联免疫单位值计算公式为:酶联免疫单位标本=犤(A标本-A空白)/(A阴性-A空白)犦×30,(A为吸光度值),酶联免疫单位≤12判定为阴性;酶联免疫单位>12判定为阳性。IgG抗体酶联免疫单位值的计算公式为酶联免疫单位标本=犤(A标本-A空白)/(A阴性-A空白)犦×130,酶联免疫单位≤45为阴性,酶联免疫单位>45为阳性。IgA抗体阳性,判定为慢性感染;IgG抗体阳性,判定为既往感染。④计量、计数资料差异性测定采用t检验,χ2检验,原发性高血压与其相关因素的不同水平之间的关联采用单因素分析;以有无原发性高血压为应变量,以性别,年龄,IgA,IgG的酶联免疫单位值,吸烟史,饮酒史,高血压家族史和总胆固醇,三酰甘油的水平为自变量,进行Logistic回归分析。结果:原发性高血压患者56例,健康者35人均进入结果分析并完成调查。①患者组和对照组肺炎衣原体IgA抗体的酶联免疫单位均值差异不明显(54.083±42.684,62.799±48.533,P>0.05);而对照组IgG抗体的酶联免疫单位均值明显高于患者组(105.804±63.054,72.641±64.277,t=2.412,P<0.05)。②患者组和对照组IgG抗体的阳性率分别为73.2%和94.3%,OR=0.166(95%CI:0.035～0.777)。③单因素分析结果显示,在各相关因素中,IgG抗体的阳性率在两组间差异明显(OR=0.166,P<0.05)。④Logistic多因素分析结果显示,肺炎衣原体IgG抗体的酶联免疫单位均值水平可能为原发性高血压的保护因素(OR=0.992)。IgA抗体的酶联免疫单位水平没有进入模型。结论:肺炎衣原体的既往感染,IgG抗体阳性可能是原发性高血压发生的一种保护因素,而其IgA抗体水平与原发性高血压的发病关联不显著。
Objective: To investigate the relationship between serum levels of Chlamydia pneumoniae IgA and IgG and essential hypertension. Methods ① Fifty-five primary and secondary school teachers recruited from Beipiao City from July 1999 to December 2001 were selected from 56 patients with hypertension, including 26 males and 30 females. Randomly drawn from this population 35 healthy subjects matched with age and sex and case group were control group, 17 males and 18 females. Subjects are informed consent. (2) When the subjects into the group to complete the self-questionnaire (including: general characteristics, smoking history, history of drinking, family history of hypertension, etc.) of the general survey; Simultaneous measurement of blood pressure, height, weight and so on. ③ serum Chlamydia pneumoniae IgA, IgG antibody ELISA kit. Chlamydia pneumoniae antibody levels in specimens are indicated by ELISA units. IgA antibody ELISA unit value formula is: ELISA unit specimen 犤 (A specimen-A blank) / (A negative-A blank) 犦 × 30, (A is the absorbance value), ELISA unit ≤ 12 Judged negative; ELISA unit> 12 judged as positive. IgG antibody ELISA unit value formula for the ELISA unit specimen = 犤 (A specimen-A blank) / (A negative-A blank) 犦 × 130, ELISA unit ≤ 45 was negative, enzyme-linked immunosorbent assay > 45 is positive. IgA antibody positive, judged as chronic infection; IgG antibody was positive, judged as previous infection. ④ measurement, counting data differences were determined by t test, χ2 test, the correlation between essential hypertension and its different levels of related factors using univariate analysis; with or without primary hypertension as the dependent variable, gender, Age, IgA, IgG, smoking history, drinking history, family history of hypertension, total cholesterol and triglyceride were independent variables and Logistic regression analysis. Results: 56 patients with essential hypertension and 35 healthy individuals entered the result analysis and completed the investigation. (1) The average value of enzyme-linked immunosorbent assay (ELISA) of patients with Chlamydia pneumoniae IgA was not significantly different (54.083 ± 42.684, 62.799 ± 48.533, P> 0.05) 105.804 ± 63.054, 72.641 ± 64.277, t = 2.412, P <0.05). The positive rates of IgG antibodies in patients and controls were 73.2% and 94.3%, respectively, OR = 0.166 (95% CI: 0.035-0.777). ③ The results of univariate analysis showed that the positive rate of IgG antibody was significantly different between the two groups (OR = 0.166, P <0.05). Logistic multivariate analysis showed that the average level of ELISA units of Chlamydia pneumoniae IgG antibody may be the protective factor of essential hypertension (OR = 0.992). IgA antibody ELISA unit levels did not enter the model. Conclusion: The past infection of Chlamydia pneumoniae, IgG antibody positive may be a protective factor of essential hypertension, and its IgA antibody level is not associated with the incidence of essential hypertension.