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目的 探讨感染负荷与冠状动脉粥样硬化及其斑块性质的相关性。方法 2001年12月至2003年10月在本院接受介入检查的患者182例,血管内超声检测确定冠状动脉粥样硬化及其斑块性质;介入检查前抽静脉血,酶联免疫吸附检测法(ELISA)检测患者血清巨细胞病毒、幽门螺旋菌、肺炎衣原体、EB病毒、B型柯萨奇病毒、A型流感病毒、B型流感病毒、结核杆菌抗体IgG/IgA及乙肝病毒表面抗原。免疫散射比浊法检测高敏C反应蛋白(hs CRP)水平。结果 根据感染负荷将患者分为三组:A组:感染原n≤3种,B组:n=4~5种和C组:n≥6种。冠状动脉粥样硬化的检出率随感染负荷的增加而增加,各组冠状动脉粥样硬化阳性率分别为44. 4%, 70 .6%和76 .7% (P<0 .001);感染负荷与动脉粥样硬化阳性率呈正相关,r=0 .9396。血清hs- CRP水平升高者( >5 .0mg/L)冠状动脉粥样硬化阳性率升高更明显(43 .8%, 70. 0%, 70.8% )比(45 .5%, 63 .7%, 96 .8% )。A、B、C组易损斑块检出率分别为33 .3%、32 .4%、51. 7% (P<0. 05 ),感染原在5种以上者易损斑块检出率明显升高。结论 以往感染微生物数量与冠状动脉粥样硬化率相关,血清hs CRP水平升高者中两者的相关性更明显, 提示二者有协同作用。高水平的感染负荷与冠状动脉粥样硬化的易损斑块率相关。
Objective To investigate the relationship between infection load and coronary atherosclerosis and plaque properties. Methods From December 2001 to October 2003, 182 patients undergoing PCI in our hospital were examined. Intravascular ultrasound was used to determine the coronary atherosclerosis and plaque characteristics. Venous blood samples were collected before intervention and detected by enzyme linked immunosorbent assay Serum cytomegalovirus, Helicobacter pylori, Chlamydia pneumoniae, Epstein-Barr virus, Coxsackievirus B virus, influenza A virus, influenza B virus, IgG / IgA antibodies to Mycobacterium tuberculosis and hepatitis B virus surface antigen were detected by ELISA. Immunostaining turbidimetry was used to detect the level of hs CRP. Results According to the infection load, the patients were divided into three groups: group A: n≤3 original infection, group B: n = 4 ~ 5 and group C: n≥6. The prevalence of coronary atherosclerosis increased with the increase of infection burden, and the positive rates of coronary atherosclerosis in each group were 44.4%, 70.6% and 76.7%, respectively (P <0.001). Infection load and positive rate of atherosclerosis was positively correlated, r = 0.9396. The positive rate of coronary atherosclerosis in patients with elevated serum hs-CRP levels (> 5.0 mg / L) was significantly higher than those in patients with elevated serum hs-CRP levels (43.8%, 70.0%, 70.8%). 7%, 96.8%). The detection rates of vulnerable plaques in group A, B and C were 33.3%, 32.4% and 51.7% (P <0.05) respectively. The vulnerable plaques in more than 5 cases were detected The rate was significantly higher. Conclusions The number of previous infected microorganisms is related to the rate of coronary atherosclerosis. The correlation between the serum hs-CRP levels and those in the serum is more obvious, suggesting that the two have synergistic effects. High levels of infection burden are associated with vulnerable atherosclerotic plaque rates.