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目的 :探讨肺炎衣原体感染和炎症对冠状动脉 (冠脉 )粥样硬化和支架内再狭窄的影响。方法 :6 2 8例接受冠脉造影检查的患者根据造影结果分为冠脉粥样硬化组 (4 33例 )和非冠脉粥样硬化组 (195例 ) ,记录两组基线临床资料 ,检测血清肺炎衣原体抗体IgA及高敏的C反应蛋白 (CRP)。 2 6 1例冠脉内放置支架的患者分为感染组 (89例 )和非感染组 (172例 ) ,随访半年 ,再次冠脉造影检查 ,测量支架内管腔丢失率。结果 :冠脉粥样硬化组肺炎衣原体抗体IgA的阳性率及滴度均高于无冠脉粥样硬化组 (4 8.32 %∶2 6 .10 % ;1.31± 1.19∶0 .92± 1.12 ) ;血清CRP水平明显升高 [(34.6 7± 3.2 4 )mg/L∶(2 3.2 2± 3.2 7)mg/L],且随着病变程度加重而增加。肺炎衣原体感染组和非感染组再狭窄发生率分别为 2 7.0 %、2 1.3% ,差异无统计学意义。但有再狭窄者血清CRP水平明显高于无再狭窄者 [(36 .13± 4 .0 4 )mg/L∶(16 .5 1± 3.92 )mg/L]。 结论 :血清抗肺炎衣原体抗体IgA阳性与冠脉粥样硬化相关 ,但不能预示支架内再狭窄的发生 ;而CRP与冠脉粥样硬化和再狭窄的发生均相关 ,提示炎症反应不仅在动脉粥样硬化而且在支架内再狭窄的发生中均扮演重要角色。
Objective: To investigate the effects of Chlamydia pneumoniae infection and inflammation on coronary atherosclerosis and in-stent restenosis. Methods: Sixty-eight patients undergoing coronary angiography were divided into coronary atherosclerosis group (433 cases) and non-coronary atherosclerosis group (195 cases) according to the results of angiography. Baseline clinical data were recorded and detected Serum Chlamydia pneumoniae antibody IgA and high-sensitivity C-reactive protein (CRP). Two hundred and sixty-one patients with coronary stent were divided into infection group (n = 89) and non-infection group (n = 172). The patients were followed up for six months. Coronary angiography was performed again to measure the intraluminal lumen loss rate. Results: The positive rate and titer of Chlamydia pneumoniae antibody IgA in coronary atherosclerosis group were higher than those in non - coronary atherosclerosis group (4.82%: 2.10% vs 1.31 ± 1.19: 0.92 ± 1.12). Serum CRP level increased significantly (34.6 7 ± 3.2 4) mg / L (2 3.2 2 ± 3.2 7) mg / L], and increased with the severity of the disease. The incidences of restenosis in Chlamydia pneumoniae and non-infected groups were 2 7.0% and 2 1.3%, respectively, with no significant difference. However, the level of serum CRP in patients with restenosis was significantly higher than those without restenosis [(36.13 ± 4.40 mg / L: (16.51 ± 3.92) mg / L]. Conclusion: Serum anti-Chlamydia pneumoniae antibodies IgA positive and coronary atherosclerosis, but can not predict the occurrence of in-stent restenosis; and CRP and coronary atherosclerosis and restenosis are related, suggesting that inflammatory response not only in atheroma Like sclerosis and plays an important role in the occurrence of in-stent restenosis.