肺炎衣原体感染与颈动脉粥样硬化相关性研究

摘要

Objectives To study the correlation between Chlamydiae Pneumonia and carotid atherosclerosis,and the correlation between the infection of Chlamydiae Pneumonia and ischemic events.Methods The study group consisted of 19 patients who underwent unilateral carotid endarterectomy surgery during the period from January 2010 to December 2011,and the atherosclerotic plaque specimens were harvested from these patients.The control group consisted of 10 patients who underwent extracranialintracranial bypass surgery during the same period,and the normal external carotid artery specimens were got from these patients.The clinical data between the two groups had comparability.The presence of Chlamydiae Pneumonia in atherosclerotic plaque and normal artery tissue were investigated by immunohistochemistry.The expression of Toll-like receptor 2 (TLR2),tumor necrosis factor-α (TNF-α) and vascular cell adhesion molecule-1 (VCAM-1) in the atherosclerotic plaque infected with Chlamydiae Pneumonia were also detected.Data were analyzed using Fisher's exact test.Results Chlamydiae Pneumonia was found in 9 of 19 atherosclerotic plaques,while no positive result was found in control group.The statistical analysis showed a significant difference(P =0.011).Among the 19 patients in study group,15 of them had ischemic events,and Chlamydiae Pneumonia was found in 9 of these 15 patients ; while the other 4 patients didn't have any ischemic events and no Chlamydiae Pneumonia was found in them,but there was no statistical different between them (P =0.087).Through immunohistochemistry,the expression of Chlamydiae Pneumonia,TLR2,TNF-α and VCAM-1 were found in same area.Conclusions There is a correlation between Chlamydiae Pneumonia and carotid atherosclerosis.And there might be a correlation between Chlamydiae Pneumonia and cerebral ischemic events.%目的 研究肺炎衣原体感染与颈动脉粥样硬化的关系,并探讨肺炎衣原体感染与脑血管缺血事件的相关性.方法 收集2010年1月至2011年12月行单侧颈动脉内膜剥脱术治疗颈动脉狭窄的19例患者的粥样硬化斑块组织(实验组),取同期行颅内外血管搭桥患者的修剪血管组织为正常对照(对照组),共10例.两组资料具有可比性.采用免疫组化方法,检测所有组织肺炎衣原体的感染情况,以及Toll样受体2(TLR2)、肿瘤坏死因子-α(TNF-α)和血管细胞黏附分子-1(VCAM-1)的表达情况,结果采用Fisher确切概率法进行统计分析.结果 实验组动脉粥样硬化斑块中肺炎衣原体阳性率为9/19,对照组中无肺炎衣原体阳性发现,差异有统计学差异(P=0.011).实验组中有脑缺血事件患者15例,肺炎衣原体阳性率为9/15；无脑缺血事件患者4例无肺炎衣原体阳性发现,但差异无统计学差异(P=0.087).肺炎衣原体、TLR2、TNF-α和VCAM-1在颈动脉粥样硬化同一区域呈阳性表达.结论 肺炎衣原体感染与颈动脉粥样硬化密切相关,肺炎衣原体感染与脑血管缺血事件发生可能具有相关性.