A Review ofChlamydia pneumoniaeand Atherosclerosis
A Review ofChlamydia pneumoniaeand Atherosclerosis
复制标题
肺炎衣原体与动脉粥样硬化的研究进展
DOI：
10.1053/ejvs.1998.0757
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发表时间：
1999
影响因子：
5.7
通讯作者：
L. Østergaard
中科院分区：
文献类型：
--
作者：
J. Lindholt;H. Fasting;E. W. Henneberg;L. Østergaard
摘要肺炎衣原体是一种革兰氏阴性专性胞内细菌，可引起急性上呼吸道和下呼吸道感染。它的分布在世界各地。血清流行病学研究表明肺炎衣原体与动脉粥样硬化以及急性心肌梗死的风险之间存在关联。几项研究已经在冠状动脉和颈动脉的动脉粥样硬化病变、腹主动脉瘤(AAA)和硬化的主动脉瓣中发现了肺炎衣原体。一项研究一直成功地从动脉粥样硬化病变中培养出肺炎衣原体，这表明存在活的生物体。然而，致病性尚不清楚，检测该生物体的意义也尚未得到解决。在两个较小的对照临床试验中，缺血性心脏病患者被随机分为抗生素治疗组和安慰剂组。两项试验都显示，接受大环内酯类药物治疗的患者严重终点显著减少。因此，大环内酯类药物似乎可以改善严重缺血性心脏病的预后。目前尚不清楚这是由根除肺炎衣原体引起的，还是由大环内酯类的非特异性抗炎作用引起的。由于肺炎衣原体和炎症都存在于腹主动脉壁，因此可以认为大环内酯类药物也可以改善腹主动脉瘤和其他与血管手术相关的疾病的预后。为了证实这一点，需要使用大环内酯类药物的随机试验，以及能够区分感染或未感染肺炎衣原体的个人的诊断方法。后者是必要的，以便澄清肺炎衣原体存在的影响，避免滥用抗菌剂。
Abstract Chlamydia pneumoniae is a Gram-negative obligate intracellular bacterium that causes acute upper and lower respiratory infections. Its distribution is worldwide. Seroepidemiological studies have shown an association between C. pneumoniae and atherosclerosis, and the risk of acute myocardial infarction. Several studies had detected C. pneumoniae in atherosclerotic lesions from coronary and carotid arteries, in abdominal aortic aneurysms (AAA), and in sclerotic aortic valves. One study consistently succeeded in culturing C. pneumoniae from an atherosclerotic lesion, indicating the presence of viable organisms. However, the pathogenicity is unknown, and the significance of detecting the organism is unresolved. In two minor controlled clinical trials, patients with ischaemic heart disease were randomised into antibiotic-treated and placebo groups. Both trials showed a significant reduction in serious endpoints in patients receiving macrolide. Macrolide therapy thus seems to improve the outcome of severe ischaemic heart disease. It is not known whether this is caused by eradicating C. pneumoniae organisms, or by the macrolide's non-specific anti-inflammatory effect. Since both C. pneumoniae and inflammation are found in the AAA wall, it may be considered that macrolide would also improve the outcome of AAA and other diseases related to vascular surgery. In order to confirm this, randomised trials with macrolide therapy are needed, as well as diagnostic methods that can differentiate between individuals who are or are not infected with C. pneumoniae . The latter are needed in order to clarify the impact of the presence of C. pneumoniae and to avoid indiscriminate use of antimicrobials.
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DOI：
10.1161/01.atv.13.10.1501
发表时间：
1993-10-01
期刊：
ARTERIOSCLEROSIS AND THROMBOSIS
影响因子：
--
作者：
KUO, CC;GOWN, AM;GRAYSTON, JT
通讯作者：
GRAYSTON, JT
影响因子：
6.4
作者：
Kalayoglu, MV;Byrne, GI
通讯作者：
Byrne, GI
DOI：
10.1016/0002-9343(93)90332-j
发表时间：
1993-11
期刊：
The American journal of medicine
影响因子：
--
作者：
S. Melnick;Eyal Shahar;A. Folsom;J. Grayston;P. Sorlie;San-Pin. Wang;M. Szklo
通讯作者：
S. Melnick;Eyal Shahar;A. Folsom;J. Grayston;P. Sorlie;San-Pin. Wang;M. Szklo
肺炎衣原体菌株 TWAR 抗体和血管造影显示冠状动脉疾病。
DOI：
10.1161/01.atv.11.3.547
发表时间：
1991
期刊：
Arteriosclerosis and thrombosis : a journal of vascular biology
影响因子：
--
作者：
Thom,DH;Wang,SP;Grayston,JT;Siscovick,DS;Stewart,DK;Kronmal,RA;Weiss,NS
通讯作者：
Weiss,NS
影响因子：
6.4
作者：
Moazed, TC;Kuo, CC;Campbell, LA
通讯作者：
Campbell, LA