老年冠心病患者血清脂联素及肺炎衣原体抗体等水平的观察.docVIP

老年冠心病患者血清脂联素及肺炎衣原体抗体等水平的观察 【摘耍】目的探讨老年冠心病(CHD)患者血清脂联素、肺炎 衣原体(Cpn)抗体及细胞间黏附分子1 (ICAM 1)等水平的变化及 其临床意义。方法临床确诊的老年CHD病人300例，以342例健 康查体者为对照组，放免法测定其血清脂联素，ELISA法检测血清 Cpn抗体及ICAM 1、C反应蛋口(CRP)、白介素 6(IL 6)水平, 同时对其作血脂分析。结果 老年CHD患者血清Cpn IgA抗体阳性 率显著高于对照组(P0.01), IgM抗体则与对照组无显著差异;急性心 肌梗死(AMI)及不稳定型心绞痛(UAP)者Cpn IgG抗体阳性率明显高 于对照组(P0.05)o CHD病人血清脂联素明显低于对照组(PvO.Ol), 而ICAM kCRP及IL 6则明显高于对照组(P0.05)o结论Cpn 抗体高阳性率及脂联素的降低与老年冠心病之间存在联系，而患者血 清ICAM 1、CRP及IL 6水平的升高也提示炎症反应在冠心病 的发生发展中起着重要作用。 【关键词】冠心病；脂联素；肺炎衣原体；黏附分子 [Abstract ] Objective To determine serum adiponectin, chlamydia pneumonia(Cpn) antibody and intercellular adhesion molecule 1 (ICAM 1) levels in elderly patients with coronary heart disease(CHD), and to find its clinical significance. Methods Serum adiponectin, Cpn antibody, ICAM 1, C reactive protein(CRP) and interleukin 6(IL 6) were determined by RIA or ELISA in 300 CHD patients and 342 normal subjects. The blood lipid level was also measured at the same time. Results The positive rate of Cpn IgA antibody in elderly CHD patients was significantly higher than that in normal people(P0.01), but there was no difference in IgM antibody. The positive rate of Cpn IgG antibody in patients with acute myocardial infarction(AMI) or unstable angina pectoris(UAP) was also significantly higher than that in normal people(P0.05). Serum adiponectin in CHD patients was lower than that in normal people. The levels of ICAM 1, CRP and IL 6 were significantly higher in CHD patients than those in normal people(P0.05). Conclusions There is an relationship between elderly CHD and high positive rate of Cpn antibody or lower level of serum adiponectin. These results indicate that high levels of ICAM 1, CRP, IL 6 and inflammation play an importment role in elderly CHD. ［Key words】 coronary heart disease; adiponectin; chlamydia pneumonia; adhesion molecule 冠心病(CHD)以动脉粥样硬化(AS)为病理基础。AS是由于各种 损伤因子反复不断刺激引发的一种以血管内局部细胞增殖、纤维增生 为基本病变的保护性炎症反应。肺炎衣原休(Cpn)感染可能作为损伤 因素2—，触发炎症反应，并通过与机体免疫系统及局部细胞间的相 互作用促进冠心病的发生发展［1］；而脂联索是市脂肪组织分泌、对血 管壁损伤