Are morphological or functional changes in the carotid artery wall associated with Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, or herpes simplex virus infection?
Are morphological or functional changes in the carotid artery wall associated with Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, or herpes simplex virus infection?
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DOI：
10.1161/01.str.31.9.2127
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发表时间：
2000-09-01
期刊：
影响因子：
8.3
通讯作者：
Meyer, J
中科院分区：
文献类型：
--
作者：
Espinola-Klein, C;Rupprecht, HJ;Meyer, J
背景与目的：肺炎衣原体、幽门螺杆菌、巨细胞病毒（CMV）和单纯疱疹病毒（HSV）的慢性感染与动脉粥样硬化的发病有关。颈动脉内膜-中膜厚度（IMT）可以用来指示早期动脉粥样硬化，颈动脉狭窄的存在是颈动脉粥样硬化明显的标志，动脉硬度的增加被用作动脉粥样硬化血管壁结构和功能改变的标志。方法：在504例患者中（75%为男性，平均年龄62.9岁[SD 10]），我们测量了颈总动脉的IMT和弹性压力模量（EP, n=445）以及颈内或颈外动脉狭窄的发生率，并采集了血液样本，评估了针对肺炎C、幽门螺杆菌、CMV和HSV 1型和2型的抗体。采用回归分析和多元逻辑回归分析进行统计评价。结果：肺炎C抗体血清阳性是IgG滴度IMT和颈动脉狭窄最高类别联合终点的独立预测因子（OR 1.8, 95% CI 1.1至3.1；校正），CMV独立增加IgG滴度和IgA滴度联合终点的风险（OR 1.7, 95% CI 1.1至2.8；校正）（OR 2.3, 95% CI 1.1至4.9；校正）。我们发现抗CMV的IgG抗体与EP有显著的相关性；HSV 2型IgG滴度与IMT和颈动脉狭窄相关，但调整后后者的结果不再显著。与幽门螺杆菌或HSV 1型无关联。结论：我们发现抗肺炎C和巨细胞病毒IgG抗体与早期和晚期颈动脉粥样硬化显著相关。CMV也与颈动脉功能改变相关，但调整后不能证实。
Background and Purpose-Chronic infection with Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus (CMV), and herpes simplex virus (HSV) has been implicated in the pathogenesis of atherosclerosis. The carotid intima-media thickness (IMT) can be taken to indicate early atherosclerosis, the presence of a carotid stenosis is a marker of a manifest carotid atherosclerosis, and an increase in arterial stiffness is used as marker of structural and functional changes in an atherosclerotic vessel wall.Methods-In 504 patients (75% men; mean age 62.9 [SD 10] years), we measured the IMT and the elastic pressure modulus (EP; n=445) of the common carotid artery and the prevalence of a internal or external carotid artery stenosis, Blood samples were taken, and antibodies against C pneumoniae, H pylori, CMV, and HSV types 1 and 2 were evaluated. Statistical evaluation was performed with regression procedures and multivariate logistic regression analyses.Results-Seropositivity for C pneumoniae was an independent predictor for a combined end point of highest category of IMT and carotid artery stenosis (OR 1.8, 95% CI 1.1 to 3.1; adjusted) for IgG titers, Independently, CMV increased the risk for the combined end point (OR 1.7, 95% CI 1.1 to 2.8; adjusted) for IgG titers and for IgA titers (OR 2.3, 95% CI 1.1 to 4.9; adjusted). We found a significant correlation between IgG antibodies against CMV and EP; HSV type 2 IgG titers were associated with IMT and carotid stenosis, but the latter results were no longer significant after adjustment. There was no association with H pylori or HSV type 1.Conclusions-We found a significant association of IgG antibodies against C pneumoniae and CMV with early and advanced carotid atherosclerosis. CMV was also correlated to functional changes of the carotid artery, but this could not be confirmed after adjustment.