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论著:肺炎衣原体感染与卒中关系的研究
Chlamydia Pneumonia Infection in Stroke Patients
段磊 任传成 倪冬艳 石蕾
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作者单位:复旦大学附属上海市第五人民医院神经内科
中文关键字:肺炎衣原体;卒中;危险因素
英文关键字:Chlamydia pneumonia; Stroke; Risk factor
中文摘要: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 ischemic 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。
英文摘要: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.
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