| PrefaceAt present, stroke has been one of the common and fre lently -occurring diseases that seriously threaten older people health with aging acceleration and incidence rate increasing of other correlation disease, such as hypertension, diabetes, hyperlipoidemia, etc. The characters of stroke were high incidence rate, high mutilation rate, high fatality rate and recurrence rate. Stroke was one of the most three causes of death and listed the first in North of China. The mortality of stroke in China and Japan were the first in world. The pathogenesis of ischemic stroke has not been clear. The traditional risk factors only account for partial reasons.Chlamydia pneumonia(C. p) is a common existing intracellular Gram negative pathogen, which can cause respiratory tract infection . Recently, several studies have demonstrated an association between C. p infection and ischemic stroke, but the results are still in argued. This study investigated the indexes of epidemiology which connecting with ischemic stroke, and measured serum im-munoglobulin A(IgA) antibody to C. p. Multiple Logistic regression was used to analysis in order to clarify the precise relationship between the antibody and ischemic stroke.Subjects and Methods1. The selection of subjects76 cases (man/female 39/37; mean age 58.71 ±7.25) was selected from ischemic stroke patients coming from Zhangwu county, 80 matched controlsubjects (man/female: 40/40; mean age: 58.06 ±9. 27) without stroke was randomly selected from the same population. The age of all subjects varied from 40 to 80. They must have no liver, kidney, connective tissue and other self — immune diseases.2. Diagnosis standard and the methods of measurementsAccording to the diagnosis standard formulated by The Fourth National Academic Congress Of Cerebrovascular Disease in 1995, and each case must be confirmed by the hospital of county grade or higher — level hospital.3. the contents of epidemiological surveyThe questionnaires were used by the way of inquiring and measurement in sites. The contents of survey included; general characteristics, family history of ischemic stroke, alcohol intake, smoking habits and so on. Five milliliters blood samples were draw from an antecubital vein after an overnight fast. After centrif-ugation, the serum fraction was removed and frozen in aliquots at - 70℃ until assayed.4. The index and methods of detecting indicatorsThe presence of specific IgA antibody to C. p was assayed using the solid -phase enzyme immunoassay (EIA) kit commercially available from Labsystems company(Labsystems, Helsinki, Finland). The concentrations of serum total cholesterol (CHOL) , high density lipoprotein cholesterol( HDL) , triglycerides (TG) were assayed by the kit commercially available from zhongsheng bio -technical company (zhongsheng, Beijing,China).5. Statistical methodsStatistical methods of dichotomous variables were by the chi - square test or Fisher's exact test. Student s t- test was used to assess differences between groups for two continuous variables. Multiple Logistic Regression was used when evaluating the effect of a continuous or categorical covariates on a dichotomous outcome. A 2 - sided value ofa =0. 05 was regarded as statistically significant. The software used was SPSS10. 0.Results1. The primary character of ischemic stroke group and control group There was not a statistical difference( p > 0.05 ) of age, weight, sex, familyhistory of ischemic stroke, HDL and TG between the two groups, but not CHOL, alcohol intake, smoking habits and hypertension(p <0.05).2. Analysis on mean values of EIU between ischemic stroke group and control group2. 1 Comparing the mean values of EIU between the two groups The mean values of EIU in ischemic stroke group and control group were 45.56 ±40. 95 and 48. 75 ±40. 72 respectively. The difference between them was not significant( P = 0. 626).2. 2 Comparing the mean values of EIU between the two groups between different age groups> 65years old: The mean values of EIU between the two groups were 58. 82 ± 38.78,43. 66 ±40.53 respectively. The difference between them was not sig-nificant(t = 1. Ill, p = 0. 275). ^65years old; The mean values of EIU between the two groups were 42. 02 ±41. 10,50. 22 ±40. 98 respectively. The difference between them was not significant (t = 1.104, p = 0. 272 ).2. 3 Comparing the mean values of EIU between the two groups between sex Man; The mean values of EIU between the two groups were 52. 15 ±39.98,53. 84 ±39. 65 respectively. The difference between them was not significant (t = 0. 189, p = 0. 851). Female: The mean values of EIU between the two groups were 38. 60 ±41. 34,43. 65 ±41. 62 respectively. The difference between them was not significant(t =0.533,p = 0.595 ).3. The distribution character of the positive rate of IgA antibody between ischemic stroke group and control group3. 1 Comparing the positive rate of IgA antibody between the two groups The positive rate of IgA antibody between the two groups were 72. 4% ffl75.0% respectively. The difference between them was not significant ( P >0.05). OR =0.873,95%CI,0.428 -1.782.stroke taking place.This study used Student -1 test to assess the mean values of the EIU of IgA antibody between the case group and control group. There was not a statistical difference. After adjusting age and sex factors, there was not a statistical difference , too. The same results were to the positive rate of IgA antibody. So we cannot say that there is relationship between C. p antibody and ischemic stroke. The concrete reason may be as follow:( 1) Different methods and different subjects: 1) Those studies which supporting there being a relationship between C. p antibody and ischemic stroke were most making use of Case - Control Study, otherwise, the studies which supporting the other opinion were most making use of Prospectively Study. Because the demonstration ability of Prospectively Study was stronger than that of Case - Control Study, we cannot exclude the false - positive outcome was resulted from the different methods. 2) Different sample: there are 76 patients in case group and the sample of our study is bigger than that of the other studies. 3) Different diagnose standard.(2) Bias control; This study using Logistic Regression analysis adjusted confounding factors and compared the positive rate and EIU of IgA antibody between age groups and sex groups. We controlled the confounding bias well.( 3 ) Differences in detecting methods and the detecting indicators: In other studies, Micro - immunofluorescence assay ( MIFA) was most used to detect the antibodies for C. p. The method is a time - consuming and subject to some operator variation method. In our study, we used the El A method to detect the IgA antibody, compared with the former methods, the EIA is a kind of quantitative method, because the detecting results of it is continuous. EIA is sensitive.In general the association between the cardiovascular diseases and C. p antibody all have not been clear. To coronary heart disease and hypertension, one hand, some studies support there were relationship between the diseases and C. p infection. The other hand, some studies report there was no relationship between them. We consecutively used EIA method to detect the C. p antibodies in coronary heart disease and hypertension patients. The results were that; there was not relationship between IgG antibody to C. p and acute myocardial infarc-...
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