| Objective: Since Fabricant inoculated human cytomegalovirus (HCMV) to turkey and made it provoking atherosclerosis (AS) in 1984, the association between HCMV and atherosclerosis have been one of hot spots of research among domestic and foreign scholars. A great quantity of epidemic documents have conformed the intimate association between HCMV and the occurrence or development of atherosclerosis. To these days, some research abroad come out that acute cardiovascular and cerebrovascular affairs , including unstable angina, myocardial infarction and stroke, have related to HCMV. Gao Yulin thought that, active infection of HCMV may be one of initiating agents of cerebral infarction and one of significant causes of pathogenetic condition progressing. The detection of cytomegaloviral late-antigen pp65 to diagnose the active infection of HCMV has been generally acknowledged. Therefore, the article analyzed the epidemiological results of the active infection of HCMV in crowds in part of Hebei province and the positive rate of HCMV-pp65 of atherosclerotic ischemic strokes, to provide evidence to approach the association between HCMV and the atherosclerotic ischemic cerebrovascular disease.Method: The immunohistochemical method was applied to detect cytomegaloviral late-antigen pp65 in leucocyte of blood. The article analyzed the epidemiological survey of the positive rate of HCMV-pp65 in crowds in part of Hebei province, and compared it with that in the group of atherosclerotic ischemic stroke (to call for short below"the stroke group").Epidemiological survey to the active infection of HCMV in crowds in parts of counties in Hebei province (except whom with stroke or immunodepression) was carried out and composed the control group. 1167 cases consisting of 454 males and 713 females were detected pp65, the mean age (55.44±9.85) years old which had no statistical difference with that of the stroke group. According to the forth nationwide diagnostic criterion of cerebrovascular disease in 1995, the stroke group of 350 cases which were diagnosted atherosclerotic stroke by clinic and imageology was chosen in out-patient clinic and hospitalization from January of 2002 to Novenber of 2006. The mean age of the stroke group consisting of 240 males and 110 females was (59±14.66) years old. Among them, 40 cases were drew bone marrow to detect pp65 at the same time. The results would be dealt with SAS 6.12 statistical software: numeration data byχ2 test, measurement data by t test, and size of testαequal to 0.05.Result1 The control group: 1167 cases (except whom with stroke or immunodepression) in Hebei province were drawn blood to detect HCMV late antigen pp65. The positive rate was calculated 19.88%, and had no statistical difference between sexes, to see Table One. That had statistical difference on living environment, occupation or education, which was lower in crowds living in town, working with culture or accepting a higher-degree education, to see Table Two. That had significant statistical difference among territories, which of Cangzhou territory was highest (36.73%), the next Baoding territory (27.14%), Shijiazhuang territory lowest(12.39%), to see Table Three Figure Three. That had no statistical difference among age stages, but which had ascending trend with advancing ages, to see Table Four and Figure Four.2 The stroke group: The positive rate of the stroke group of 350 cases was 35.17%. That had no statistical difference between sexes, to see Table Five. Among them, 40 cases were drew bone marrow to detect pp65 at the same time. The positive rate of pp65 was 57.14%, which had no statistical difference compared with that of pp65 from blood (40.48%), to see Table Six.3 Therefore, the positive rate of pp65 had no statistical difference between sexes in the stroke and the control groups. The ages had no statistical difference between the two groups, to see Table Seven. The two groups were of comparability.4 Compared the stroke group with the control one, the positive rate of pp65 had statistical difference, to see Table Eight. It demonstrated that pp65 had statistically association with the incidence of stroke. To move forward a single step, relative risk (RR) was calculated 2.24, and its 95% confidence interval [1.73, 2.90]. So to speak, there was 95% chances that risk for stroke among the pp65-positive was 1.73～2.90 times greater than that among the pp65-negative. Active infection of HCMV had association with atherosclerotic ischemic cerebrovascular diseases.Conclusions1 Active infection of HCMV precisely existed among immunocompetent health crowd. This could be used to explain why 40% of people without traditionary atherosclerotic risk factors had developed atherosclerosis or stroke really.2 The positive rate of pp65 had statistical difference on living environment, occupation or education, which was lower in crowds living in town, working with culture or accepting a higher-degree education; That had significant statistical difference among territories, which of Cangzhou territory was highest (36.73%), the next Baoding territory (27.14%), Shijiazhuang territory lowest(12.39%); although the active infection of HCMV had no statistically association with sexes and ages, the positive rate of pp65 had ascending trend with advancing ages.3 The positive rate of pp65 in bone marrow was higher than that in blood. Although that had no statistical difference between the two above, the detection of pp65 in bone marrow was more sensitive, and more accurate.4 There was association between HCMV and atherosclerotic ischemic cerebral infarction. To move forward a single step, relative risk was 2.24, and its 95% confidence interval [1.73, 2.90]. There was 95% chances that risk for stroke among the pp65-positive was 1.73～2.90 times greater than that among the pp65-negative.5 Actively cytomegaloviral infection may be an independent risk factor for acute cerebrovascular affairs. Clinical detection for cytomegaloviral late-antigen pp65 could possibly provide information with regard to acute cerebrovascular diseases and serve as a monitoring indicatrix of antiviral drug treatment and prognosis. |
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