【摘要】 目的探讨巨细胞病毒(CMV)感染与急性心肌梗死的关系。方法分别采用酶联免疫法和聚合酶联反应(PCR)技术测定51例急性心肌梗死、42例陈旧性心肌梗死患者及冠脉造影正常的31例正常对照者、33例非冠心病患者血CMV抗体水平及DNA,同时检测各组的血脂、纤维蛋白原(Fg)、血液流变特性变化。结果急性心肌梗死组(治疗前)CMVIgG、CMVIgM阳性率及水平显著高于正常对照组、非冠心病组(P均<0.01),CMVDNA检测结果与之吻合。校正冠心病危险因素前、后,CMVIgG阳性与急性心肌梗死均有相关性(OR3.262,P=0.021;OR3.047,P=0.030)。急性心肌梗死组与其它3组比较,IgG、Fg、ηb(10s-1)、ηb(150s-1)、ηp、HCT、EAI显著升高,TK显著降低(P<0.01或P<0.05);与非冠心病组、正常对照组比较,TC、TG、LDL-C明显升高,而HDL明显降低(P均<0.05)。急性心肌梗死组中CMVIgG(+)与CMVIgG(-)患者比较,TC、TG、LDL-C、IgG、Fg、ηb(10s-1)、ηb(150s-1)、ηp、EAI显著升高,TK显著降低(P<0.01或P<0.05);IgG与TC、LDL-C、Fg、ηb(10s-1)、ηb(150s-1)、ηp、EAI呈正相关,与TK呈负相关。结论急性CMV感染与急性心肌梗死的发生有关,可能是后者的促发因素。CMV可能通过急性和持续性感染触发和加重冠脉内炎症反应、血栓形成、微循环功能障碍、血脂异常,参与动脉粥样硬化、急性心肌梗死的病理过程。更多还原

【Abstract】 Objective To investigate the correlations between cytomegalovirus(CMV) infection and acute myo-cardial infarction(AMI).Method Specific antibodies and DNA to CMV were measured in 51 patients with AMI (AMI group),42 patients with old myocardial infarction(OMI group) and 31 normal controls(N group), 33 patients (UC group)who had no angiographic evidence of coronary artery disease.Moreover,the changes of and relation-ships between serum lipids,fibrinogen(Fg),hemorheological parameters and CMV infection were determined in the four groups.Results The prevalence of CMVIgG antibody was associated with AMI(OR 3.262).Adjustment for the major cardiovascular risk factors didn,t attenuate this correlation(OR3.047).The levels of IgG,Fg, plasma viscosity(ηp),whole blood viscosity(ηb) at 150s-1/10s-1,Hematocrit and erythrocyte aggregation index(EAI) were significantly higher,while the the levels of erythrocyte deformation index(TK) were significantly lower in the AMI group than that in the rest groups.Those who were IgG-positive in the AMI groups had significantly higher levels of TC,LDL-C, IgG,Fg,ηp,ηb(10s-1),ηb(150s-1)and EAI, and a significantly lower levels of TK than those who were IgG-negative in the same group. Correlation analysis revealed that the average concentration of IgG antibody to CMV was positively associated with the levels of TC,LDL-C,Fg,ηp,ηb(10s-1) andηb(150s-1),but negatively associated with the level of TK in the IgG-positive patients of the AMI groups.Conclusion There is a significant correlation between acute CMV infection and AMI. Maybe the CMV infection,by inducing and accelerating inflammation and thrombosis in coronary artery, microcirculation dysfunction and abnormal lipid metabolism involves in the pathogenesis of atherosclerosis and myocardial infarction.更多还原