人類巨細胞病毒感染與冠狀動脈疾病之相關性

The Correlation between Cytomegalovirus Infection and Coronary Artery Disease

廖永樑(Yung-Liang Liao) ； 楊義爵(Yi-Chueh Yang) ； 洪鼎鈞(Ting-Chun Hung) ； 葉慧儀(Hui-Yi Yap) ； 陳家鋒(Chia-Fong Chen) ； 廖東南(Tung-Nan Liao) ； 林靖南(Ching-Nan Lin)

《內科學誌》 18卷2期 (2007/04) Pp. 88-96

https://doi.org/10.6314/JIMT.2007.18(2).04

摘要

Primary CMV infection is usually asymptomatic and results in latent, lifelong persistence of the viral genome. Periodically, the virus might reactivate from latency and regain its ability to multiply. CMV is a major cause of life-threatening illness in immunocompromised patients. Various lines of evidence suggest that chronic inflammation is involved in the initiation and progression of atherosclerosis and its complications including coronary artery disease (CAD). Several infectious agents, particularly CMV, have been suggested to play a role in the development of atherosclerosis. In this study, we measured serum levels of IL-6, anti-CMV IgG (α CMV IgG), high sensitivity C-reactive protein (hs-CRP) by ELISA or nephelometry, CMV qualitative analysis by nested PCR, and CMV viral load quantitative analysis by real time PCR in 93 CAD patients and 60 normal healthy controls. Our study showed that the levels of IL-6, and hs-CRP were significantly increased in patients with CAD (p=0.002 and p＜0.001, respectively). There was no statistical significance in α CMV IgG positive rate in both groups, however, there was a trend for higher antibody titers in the CAD group according to the quartile levels of analysis (p=0.078). In nested PCR positive cases, the CMV viral loads were significantly elevated in CAD patients than in normal controls (p＜0.05); meanwhile, there was no difference in CMV positive rates between the two groups using nested PCR qualitative assay. Conclusion: In CMV nested PCR positive cases, CMV viral loads were significantly elevated in CAD patients than in normal controls. However, there were no differences in CMV nested PCR and CMV IgG positive rates between the two groups.

關鍵字

人類巨噬細胞病毒 ； 冠狀動脈疾病 ； 介白素－6 ； 高感度C反應蛋白

並列摘要

Primary CMV infection is usually asymptomatic and results in latent, lifelong persistence of the viral genome. Periodically, the virus might reactivate from latency and regain its ability to multiply. CMV is a major cause of life-threatening illness in immunocompromised patients. Various lines of evidence suggest that chronic inflammation is involved in the initiation and progression of atherosclerosis and its complications including coronary artery disease (CAD). Several infectious agents, particularly CMV, have been suggested to play a role in the development of atherosclerosis. In this study, we measured serum levels of IL-6, anti-CMV IgG (α CMV IgG), high sensitivity C-reactive protein (hs-CRP) by ELISA or nephelometry, CMV qualitative analysis by nested PCR, and CMV viral load quantitative analysis by real time PCR in 93 CAD patients and 60 normal healthy controls. Our study showed that the levels of IL-6, and hs-CRP were significantly increased in patients with CAD (p=0.002 and p＜0.001, respectively). There was no statistical significance in α CMV IgG positive rate in both groups, however, there was a trend for higher antibody titers in the CAD group according to the quartile levels of analysis (p=0.078). In nested PCR positive cases, the CMV viral loads were significantly elevated in CAD patients than in normal controls (p＜0.05); meanwhile, there was no difference in CMV positive rates between the two groups using nested PCR qualitative assay. Conclusion: In CMV nested PCR positive cases, CMV viral loads were significantly elevated in CAD patients than in normal controls. However, there were no differences in CMV nested PCR and CMV IgG positive rates between the two groups.

並列關鍵字

Cytomegalovirus ； CMV ； Coronary artery disease ； CAD ； Interleukin-6 ； IL-6 ； High sensitivity C-reactive protein ； Hs-CRP