目的 研究强直性脊柱炎(as)患者体内血液循环和关节腔内肺炎衣原体感染情况,寻找肺炎衣原体导致as的临床证据.方法 收集33例as患者和22名健康献血者的外周血,酶联免疫法(elisa)检测血清中igg/igm抗体,免疫荧光法(ifa)和聚合酶链反应(pcr)检测外周血单个核细胞中衣原体脂多糖(lps)抗原和肺炎衣原体核酸,同时收集患者的临床资料.另采用免疫组织化学法检测9例髋关节置换的as患者和13例骨折患者滑膜中的衣原体lps抗原.结果 as患者外周血肺炎衣原体igm、lps和pcr的阳性率均显著高于健康献血者(分别为78.8％vs.22.7％,x2=16.867,p=0.000;66.7％vs.31.8％,x2 =6.431,p=0.011;33.3％vs.9.1％,x2 =4.298,p=0.038).肺炎衣原体pcr阳性与红细胞沉降率(esr)和c反应蛋白(crp)水平相关(z=-2.774 和-2.829,p值均为0.004).77.8％ (7/9)的as患者的滑膜中可检测到含有衣原体lps抗原的炎性细胞,而骨折患者滑膜中仅30.8％ (4/13)病例中检测到含有衣原体lps抗原的炎性细胞(p=0.08).结论 肺炎衣原体在as患者外周血和滑膜中有很高的感染率,肺炎衣原体感染可能与as 发病相关.
abstract：
objective to investigate the association of chlamydia pneumoniae infection with ankylosing spondylitis (as).methods serum samples were obtained from 33 as patients and 22 healthy ***-linked immunosorbent assay (elisa) was applied to mearsure serum anti-chlamydia pneumoniae antibodies (igm/igg),while immunofluorescence assay (ifa) was used to detect chlamydia pneumoniae lps antigen,and polymerase chain reaction (pcr) was used to amplify chlamydia pneumoniae dna in peripheral blood cells. immunohistochemistical technique was applied to examine chlamydia pneumoniae lps antigen in synovial tissue from another 9 as patients who received total hip replacement and 13 patients with comminuted femoral *** the positive rates of chlamydia pneumoniae igm,lps antigen and chlamydia pneumoniae dna were higher in as patients than those in healthy controls (78.8％ vs 22.7％,x2 =16.867,p =0.000; 66.7％ vs 31.8％,x2 =6.431,p =0.011; 33.3％ vs 9.1％,x2 =4.298,p =0.038).chlamydia pneumoniae dna positive rate was correlated with erythrocyte sedimentation rate (esr) and c-reactive protein (crp) levels (z =-2.774 and -2.829,p =0.004).in synovial tissues,chlamydial lps-containing inflammatory cells were observed in 77.8％ (7/9) as patients,while those in fracture patients was 30.8％ ( 4/13 ) ( p =0.08 ).conclusion chlamydia pneumoniae infection is common in blood circulation and joint cavity of as patients a
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