| Objective: Cerebral infarction in clinical practice is a common, frequently-occurring disease, which is characterized by irreversible brain tissue necrosis caused by varieties of hypoxia-ischemia causes. Common risk factors for cerebral infarction are hyperlipidemia, hypertension, diabetes, substantial smoking and emboli embolism. However, many cerebral infarction can not be explained using these traditional risk factors. Chlamydia pneumoniae is a common respiratory pathogens which have a high rate of infection in the crowd, and it is a gram-negative intracellular parasitic pathogen, can metabolize in the cell and exist in vivo for a long time, which makes the pathogen maintain a state of chronic infection possible. Some studies have been reported claiming that chlamydia pneumoniae were found in atherosclerotic tissue and played a role in the progress of atherosclerosis. Some case-control study also show that Cpn-IgA as a marker of persistent and chronic infection is an independent risk factor of atherosclerotic cerebral infarction, and some prospective studies also supported this view. But not all studies are consistent with this view. In this study, we detect various types of antibodies against Chlamydia pneumoniae in the serum of the cerebral infarction patients with traditional risk factors, the cerebral infarction patients without any traditional risk factors and healthy control group to further explore the association between the infection of chlamydia pneumoniae and cerebral infarctionMethods: The subjects from the in-patients of the department of neurology of the Second Hospital Of Hebei Medical University and the healthy people for physical examination in our hospital during March 2008 to November 2008, are divided into three groups. The first group(referred to as high-risk group), the cerebral infarction patients aged 30-60years,including 20 men and 25 women and with risk factors such as substantial smoking, hyperlipidemia, hypertension, diabetes and so on, are characterized by the clinical manifestations of neurological deficits caused by a larger arterial pathological changes not including the hemiparesis syndrome of pure motor , pure sensory , sensorimotor, ataxic etc and so on, and have a fresh infarct lesion the size of which in the images of CT or MRI is more than 1.5cm~2. And all the Subjects have been confirmed without cerebral vascular malformation by MRA and ruled out the possibility of atrial fibrillation and blood disease. The second group (referred to as non-risk group), the cerebral infarction patients aged 30-60 years, including 16 men and 20 women and without any risk factors such as substantial smoking, hyperlipidemia, hypertension, diabetes and so on, are characterized by the clinical manifestations of neurological deficits caused by a larger arterial pathological changes not including the hemiparesis syndrome of pure motor, pure sensory, sensorimotor, ataxic etc and so on, and have a fresh infarct lesion the size of which in the images of CT or MRI is more than 1.5cm~2. And all the Subjects have been confirmed without cerebral vascular malformation by MRA and ruled out the possibility of atrial fibrillation and blood disease. The third group(referred to as the control group) aged 30-60 years, including 20 men and 25women are healthy people for physical examination in our hospital who not have a history of cardiovascular and cerebrovascular diseases nor any risk factors such as heavily smoking, hyperlipidemia, hypertension, diabetes and so on. 5ml fasting blood were pumped from each of the subjects in the early morning and serum was separated at 2000r/min. ELISA kits were used to detect Cpn IgM, IgG, IgA and SPSS13.0 was used to analyse the difference of seropositive rate between two groups of cerebral infarction and the control group and the two groups of cerebral infarction.Results:1 The rate of Cpn IgM Seropositivity is 55.6% in the high-risk group, 69.4% in non-risk group and 46.7% in control group, and the Seropositive rate of the two groups of cerebral infarction are respectively compared with the control group, the values of P are respectively 0.3990 (>0.05),0.0397 (<0.05). so the difference between the high-risk group and the control group is not significant and the difference between the non-risk group and the control group is significan. OR(Odds ratio) and 95% CI (confidence interval) of Cpn IgM Seropositivity in two groups of cerebral infarction are respectively 1.43(0.62~3.28), 2.60(1.05~6.46). The Cpn IgM Seropositive rate of the two groups of cerebral infarction compare with each other, the value of P is 0.2013 (>0.05), so the difference is not significant.2 The rate of Cpn IgG Seropositivity is 73.3%% in high-risk group, 72.2% in non-risk group and 75.6% in control group, and the Seropositive rate of the two groups of cerebral infarction are respectively compared with the control group, the values of P are respectively 0.8090 (>0.05), 0.7337 (>0.05), so the difference is not significant. OR and 95% CI of Cpn IgG Seropositivity in two groups of cerebral infarction are respectively0.89(0.35~2.29), 0.84(0.31~2.29). The CpnIgG Seropositive rate of the two groups of cerebral infarction compare with each other, the value of P is 0.9110 (>0.05), so the difference is not significant.3â‘ When we think concentration of Cpn IgA more than 0.25IU/ml to be positive, the rate of Cpn IgA seropositivity is 37.8%% in high-risk group, 30.6% in non-risk group and 28.9% in control group. And the Seropositive rate of the two groups of cerebral infarction are respectively compared with the control group, the values of P are respectively 0.3711 (>0.05), 0.8703 (>0.05), so the difference is not significant. OR and 95% CI of Cpn IgA Seropositivity in two groups of cerebral infarction are respectively 1.49(0.62~3.57), 1.08(0.43~2.72). The Cpn IgA Seropositive rate of the two groups of cerebral infarction compare with each other, the value of P is 0.4971 (>0.05), so the difference is not significant.â‘¡When we think concentration of cpn IgA more than 0.50IU/ml to be positive, the rate of Cpn IgA Seropositivity is 33.3% in high-risk group, 13.9% in non-risk group and 13.3% in control group. And the Seropositive rate of the two groups of cerebral infarction are respectively compared with the control group, the values of P are respectively 0.0249 (<0.05), 1.0000 (>0.05), so the difference between the high-risk group and the control group is significant and the difference between the non-risk group and the control group is not significan. OR and 95% CI of Cpn IgA Seropositivity in two groups of cerebral infarction are respectively3.25(1.16~9.10), 1.05(0.28~3.90). The Cpn IgA Seropositive rate of the two groups of cerebral infarction compare with each other, the value of P is 0.0437 (<0.05), so the difference is significant.Conclusions1 CpnIgM Seropositivity of the non-risk group is more than that of the control, and IgM is the marker of acute infection of chlamydia pneumoniae, so we think that acute infection of chlamydia pneumoniae maybe has relation with the cerebral infarction without traditional risk factors.2 CpnIgG Seropositivity of three groups is more than 70%, the difference is not significan, so we think the rate of the infection of Chlamydia pneumoniae in the crowd is very high. 3 When we think concentration of cpn IgA more than 0.50IU/ml to be positive, the CpnIgA seropositivity of the high-risk is more than that of the non-risk and the control, and IgA is believed the marker of chronic and persistent infection of chlamydia pneumoniae, so we think that chronic and persistent infection of chlamydia pneumoniae has relation with the cerebral infarction with traditional risk factors. |
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