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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、42例陈旧性心肌梗死患者及冠状动脉造影正常的31例健康者、33例非冠心病患者血Cpn抗体水平及DNA,同时观测纤维蛋白原(Fg)、6酮前列腺素F1α(6KetoPGF1α)、血栓素B2(TXB2)、P选择素(GMP140)变化。结果急性心肌梗死组CpnIgG、CpnIgM阳性率及水平高于健康对照组、非冠心病组,CpnDNA检测结果与之吻合。校正冠心病危险因素前、后CpnIgG阳性与急性心肌梗死均有相关性(OR=3.65,P=0.025;OR=3.17,P=0.033)。急性心肌梗死组中Cpn(+)组与Cpn(-)组比较,Fg、TXB2、GMP140水平显著升高,6KetoPGF1α水平显著降低(均为P<0.01);IgG与Fg、TXB2、GMP140呈正相关,与6KetoPGF1α呈负相关。结论Cpn感染与急性心肌梗死存在明显的相关性,与Fg、TXB2、6KetoPGF1α及GMP140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 The levels of Cpn antibody and DNA in 51 patients with acute myocardial infarction, 42 patients with old myocardial infarction and 31 patients with normal coronary angiography and 33 patients with non-coronary heart disease were measured. The levels of Fg and 6 Prostaglandin F1α (6KetoPGF1α), thromboxane B2 (TXB2), P-selectin (GMP140). Results The positive rate and level of CpnIgG and CpnIgM in AMI group were higher than those in healthy control group and non-CHD group. CpnDNA test results were consistent with those in non-CHD group. Correlation between CpnIgG positive and acute myocardial infarction before and after the correction of coronary risk factors (OR = 3.65, P = 0.025; OR = 3.17, P = 0.033). The levels of Fg, TXB2 and GMP140 in Cpn (-) group and Cpn (-) group were significantly increased and the levels of 6KetoPGF1α were significantly decreased in AMI group (all P <0.01). There was a positive correlation between IgG and Fg, TXB2 and GMP140 There was a negative correlation with 6KetoPGF1α. Conclusions There is a significant correlation between Cpn infection and acute myocardial infarction. There is also a correlation between Cpn infection and Fg, TXB2, 6KetoPGF1α and GMP140.