摘要
目的探讨肺炎衣原体(chlamydia pneumoniae,CP)感染和脑梗死的关系。方法计算机检索MEDLINE、BIOSIS、重庆维普期刊数据库和中国期刊全文数据库,按纳入和排除标准收集研究CP和脑梗死关系的病例对照研究。检索时间范围为1990年1月至2007年12月。评价纳入研究质量后,采用RevMan4.2软件进行Meta分析。结果共纳入22个研究。Meta分析结果显示:①以微量免疫荧光(MIF)法检测CP抗体,当以IgA≥116为截断值时,脑梗死组CP血清学阳性率明显高于对照组[n=8,OR=2.18,95%CI(1.49,3.49)];以IgA≥132为截断值时,两组CP血清学阳性率差异无统计学意义[n=3,OR=1.47,95%CI(0.97,2.24)];以IgG≥132[n=6,OR=1.24,95%CI(0.82,1.86)]和IgG≥164[n=5,OR=1.23,95%CI(0.98,1.55)]为截断值时,两组CP血清学阳性率差异均无统计学意义;②以ELISA法检测CP-IgG抗体,脑梗死组CP血清学阳性率明显高于对照组[n=8,OR=2.40,95%CI(1.42,4.06)];③CP急性感染[n=4,OR=7.22,95%CI(2.68,19.49)]和慢性感染[n=4,OR=4.30,95%CI(3.40,7.40)]均与脑梗死的发病相关。结论①CP感染和脑梗死发病的相关性因血清阳性标准而异,采用血清IgA抗体为检测指标比IgG抗体更敏感,以血清IgA抗体滴度≥116为阳性判断标准时,显示CP感染和脑梗死相关;②以ELISA法检测CP-IgG抗体提示,CP感染和脑梗死相关,且结果稳定性较好;③CP急性和慢性感染均与脑梗死相关,但尚需大样本、科学设计的流行病学研究来进一步证实。
Objective To review the association between chlamydia pneumoniae （CP） infection and cerebral infarction. Methods We electronically searched MEDLINE, BIOSIS, VIP database, and China Full Text Journal Database from Jan. 1990 through Dec. 2007 to identify case-control studies about the association of CP and cerebral infarction. The quality of the included studies was assessed and the RevMan 4.2 software was used for meta-analyses. Results A total of 22 studies were included. The results of meta-analyses showed： （1） When the microimmunofluorescence （MIF） method was used to examine CP antibody in serum, the positive rate of the cerebral infarction group was higher than that of the control group when the positive infection was defined by IgA ≥ 1：16 （n=8, OR=2.18, 95%CI （1.49 to 3.49）, P〈0.0001]; but when positive infection was defined by IgA ≥ 1：32 （n=3）, IgG ≥ 1：32 （n=6）, or IgG ≥ 1：64 （n=5）, there were no significant differences in the positive rate between the two groups [OR （95% CI） were 1.47 （0.97 to 2.24）, 1.24 （0.82 to 1.86）, and 1.23 （0.98 to 1.55）, respectively]; （2） When the ELISA method was used to examine CP-IgG antibody in serum, the positive rate of the cerebral infarction group was higher than that of the controlled group In=8, OR=2.40, 95%CI （1.42 to 4.06）, P=0.000 2]. （3） The acute and chronic CP infections were associated with the incidence of cerebral infarction In=4, OR=7.22, 95%CI （2.68 to 19.49）; n=4, OR=4.30, 95%CI （3.40 to 7.40）]. Conclusion （1） The association between CP infection and cerebral infarction is determined by the positive criterion. IgA antibody is more sensitive than the IgG antibody. When the positive infection is determined by IgA ≥ 1：16, CP infection is associated with cerebral infarction. （2） The results of ELISA for examining CP-IgG support the association between CP infection and cerebral infarction. （3） Both acute and chronic CP infections are associated with cerebral infarction, but these associations needed to be proven by more scientific studies.
出处
《中国循证医学杂志》
CSCD
2009年第8期855-861,共7页
Chinese Journal of Evidence-based Medicine
关键词
脑梗死
肺炎衣原体
META分析
感染
Cerebral infarction
Chlamydia pneumoniae
Meta-analysis
Infection
