심근경색과 Chlamydophila pneumoniae, Cytomegalovirus, Helicobacter pylori 및 HIV 감염의 관련성
Association of Chlamydophila pneumoniae, Cytomegalovirus, Helicobacter pylori and HIV Infections with Myocardial Infarction
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배경:흔한 감염인자인 Chlamydophila pneumoniae, cytomegalovirus (CMV), Helicobacter pylori, HIV 감염과 심근경색과의 관련성에 대한 보고들이 있다. 본 연구에서는 혈청학적 검사로 C. pneumoniae, CMV, H. pylori 및 HIV 감염과 심근경색의 관련 여부를 알아보고자 하였다. 방법:급성 심근경색으로 확진된 환자 54명과 심근경색의 과거력이 있는 사람 33명, 건강 대조군 60명을 대상으로 혈청을 얻었다. 염증표지자인 C-반응 단백(C-reactive protein, CRP)을 측정하였으며 ELISA법으로 C. pneumoniae, CMV, H. pylori, HIV 항체검사를 하여 대조군에 대한 교차비(Odds ratio, OR)를 산출하였다. 결과:CRP는 급성 심근경색 환자군과 심근경색의 과거력이 있는 군 모두에서 대조군보다 유의하게 증가되었다. C. pneumoniae 감염의 교차비는 급성 심근경색 환자군(IgM 1.57, IgG 4.80)과 심근경색의 과거력이 있는 군(IgM 2.42, IgG 5.18)에서 비교적 크게 증가되었다. CMV 감염의 교차비는 급성 심근경색 환자군에서 3.30, 심근경색의 과거력이 있는 군에서 5.12로 나타났다. H. pylori 감염의 교차비는 급성 심근경색 환자군과 심근경색의 과거력이 있는 군 모두에서 1 이하로 나타났다. 항-HIV 항체검사는 세 군 모두 음성으로 나와 교차비를 산출할 수 없었다. 결론:C. pneumoniae와 CMV 감염이 각각 심근경색의 하나의 위험인자가 될 수 있을 것으로 사료되며H. pylori 감염은 교차비가 1 이하로 나타나 H. pylori 감염과 심근경색의 관련성은 없는 것으로 보인다.
Abstract
Background: There is some evidence linking the infections with common organisms such as Chlamydophila pneumoniae, cytomegalovirus (CMV), Helicobacter pylori and HIV to myocardial infarction (MI). We had performed a serologic study to assess whether C. pneumoniae, CMV, H. pyloriand HIV infections are associated with MI. Methods: Serum samples were obtained from 54 cases of acute MI, 33 cases of old MI, and 60 normal controls. C-reactive protein (CRP) as an inflammation marker was measured and antibodies to C. pneumoniae, CMV, H. pyloriand HIV were assayed by ELISA. Odds ratios (OR) were calculated against control group. Results: CRP was significantly higher in the acute MI and old MI group. ORs of C. pneumoniae infection increased considerably in the acute MI (IgM 1.57, IgG 4.80) and old MI group (IgM 2.42, IgG 5.18). ORs of CMV infection were 3.30 in the acute MI and 5.12 in old MI group. ORs of H. pylori infection showed below 1 in the acute MI and old MI. Anti-HIV antibody showed all negative result in three groups, so OR could not be calculated. Conclusion: C. pneumoniaeand CMV infections appear to be risk factors for MI.
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