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Objective To evaluate the relationship between infection burden and coronary atherosclerosis and the plaque feature. Methods One hundred and eighty two patients underwent coronary angiography in Zhongshan Hospital from 2002-2003. Atherosclerosis and vulnerable plaque were determined by intravascular ultrasound (IVUS). Seropositivity of cytomegalovirus, helicobacter pylori, chlamydia pneumonia, hepatitis B virus, EB virus, CoxB virus, influenza A virus, influenza B virus and mycobacterium tuberculosis were... Objective To evaluate the relationship between infection burden and coronary atherosclerosis and the plaque feature. Methods One hundred and eighty two patients underwent coronary angiography in Zhongshan Hospital from 2002-2003. Atherosclerosis and vulnerable plaque were determined by intravascular ultrasound (IVUS). Seropositivity of cytomegalovirus, helicobacter pylori, chlamydia pneumonia, hepatitis B virus, EB virus, CoxB virus, influenza A virus, influenza B virus and mycobacterium tuberculosis were determined by ELISA. The serum hs-CRP was detected by Dade Behring prospect ( Immuno-nehelomitery). Patients were divided into three groups according to the pathogen burden: group A, n≤3,group B, n=4-5 and group C, n≥6. Results The pathogen burden was independent of the C-reactive protein level. Increasing pathogen burden was significantly associated with increasing atherosclerosis risk, the prevalence of atherosclerosis was 44.4%,70.6% and 76.7% in group A, B and C. The risk associated with elevated pathogen burden was much higher when CRP was also elevated(>5.0 mg/L) (43.8%, 70.0%, 70.8%)vs(45.5%, 63.7%, 96.8%). The positively of vulnerable plaque increased significantly when the pathogen burden was high(n>5)(33.3%, 32.4% and 51.7% P<0.05). Conclusion Our data suggested that infection burden was associated with prevalence of coronary atherosclerosis,and it was particularly important when C-reactive protein was elevated. The high level infection burden could predict vulnerable plaque. 目的 探讨感染负荷与冠状动脉粥样硬化及其斑块性质的相关性。方法 2001年12月至2003年10月在本院接受介入检查的患者182例,血管内超声检测确定冠状动脉粥样硬化及其斑块性质;介入检查前抽静脉血,酶联免疫吸附检测法(ELISA)检测患者血清巨细胞病毒、幽门螺旋菌、肺炎衣原体、EB病毒、B型柯萨奇病毒、A型流感病毒、B型流感病毒、结核杆菌抗体IgG/IgA及乙肝病毒表面抗原。免疫散射比浊法检测高敏C反应蛋白(hs CRP)水平。结果 根据感染负荷将患者分为三组:A组:感染原n≤3种,B组:n=4~5种和C组:n≥6种。冠状动脉粥样硬化的检出率随感染负荷的增加而增加,各组冠状动脉粥样硬化阳性率分别为44. 4%, 70 .6%和76 .7% (P<0 .001);感染负荷与动脉粥样硬化阳性率呈正相关,r=0 .9396。血清hs- CRP水平升高者( >5 .0mg/L)冠状动脉粥样硬化阳性率升高更明显(43 .8%, 70. 0%, 70.8% )比(45 .5%, 63 .7%, 96 .8% )。A、B、C组易损斑块检出率分别为33 .3%、32 ... 目的 探讨感染负荷与冠状动脉粥样硬化及其斑块性质的相关性。方法 2001年12月至2003年10月在本院接受介入检查的患者182例,血管内超声检测确定冠状动脉粥样硬化及其斑块性质;介入检查前抽静脉血,酶联免疫吸附检测法(ELISA)检测患者血清巨细胞病毒、幽门螺旋菌、肺炎衣原体、EB病毒、B型柯萨奇病毒、A型流感病毒、B型流感病毒、结核杆菌抗体IgG/IgA及乙肝病毒表面抗原。免疫散射比浊法检测高敏C反应蛋白(hs CRP)水平。结果 根据感染负荷将患者分为三组:A组:感染原n≤3种,B组:n=4~5种和C组:n≥6种。冠状动脉粥样硬化的检出率随感染负荷的增加而增加,各组冠状动脉粥样硬化阳性率分别为44. 4%, 70 .6%和76 .7% (P<0 .001);感染负荷与动脉粥样硬化阳性率呈正相关,r=0 .9396。血清hs- CRP水平升高者( >5 .0mg/L)冠状动脉粥样硬化阳性率升高更明显(43 .8%, 70. 0%, 70.8% )比(45 .5%, 63 .7%, 96 .8% )。A、B、C组易损斑块检出率分别为33 .3%、32 .4%、51. 7% (P<0. 05 ),感染原在5种以上者易损斑块检出率明显升高。结论 以往感染微生物数量与冠状动脉粥样硬化率相关,血清hs CRP水平升高者中两者的相关性更明显, 提示二者有协同作用。高水平的感染负荷与冠状动脉粥样硬化的易损斑块率相关。 Objective:To establish a real-time fluorescent quantitative PCR method for determining the BK virus(BKV) level in renal transplant recipients,and to evaluate its clinical application.Methods: Plasmids containing part of BKV VP1 gene conservative region were constructed as external standards,and a TaqMan probe technique was used to establish a quantitative method for determination of BKV.Urine and peripheral blood(PB) samples from 112 renal transplant recipients were assayed for BK virus levels,and the results... Objective:To establish a real-time fluorescent quantitative PCR method for determining the BK virus(BKV) level in renal transplant recipients,and to evaluate its clinical application.Methods: Plasmids containing part of BKV VP1 gene conservative region were constructed as external standards,and a TaqMan probe technique was used to establish a quantitative method for determination of BKV.Urine and peripheral blood(PB) samples from 112 renal transplant recipients were assayed for BK virus levels,and the results were compared with those of 40 healthy controls.Results: The real-time fluorescent quantitative PCR assay established in this study had good sensitivity,specificity,and reproducibility.The minimal detectable level was 8×10~(2)copy/ml,intro-experiment variation was 0.54%-3.78%,and intra-experiment variation was 0.62%-4.58%.BKV was detected in 27.7% urine samples and 11.6% PB samples from patients.The median level of BKV in urine and PB were(8.2×)10~(4)copy/ml and 2.4×10~(3)copy/ml,respectively.BKV positive rate of 40 healthy population in urine and PB samples were 2.5% and 0%,respectively.The positive rate and level of BKV in renal transplant recipients were both significantly higher than those in normal cohort(both P<0.01).The positive rate of BKV in urine samples were significantly higher than that in PB samples(P=(0.02),)but the BKV load in urine samples was not related to that in PB samples.Conclusion: The real-time fluorescent quantitative PCR assay in this study is simple,reliable,and precise,which lays a foundation for future study of the relationship between BKV infection and renal graft loss. 目的:建立肾移植术后患者尿液和外周血BK病毒(BKV)感染负荷的实时荧光定量PCR检测方法,并初步探讨其临床应用价值。方法:构建含有BKV VP1蛋白保守区核苷酸序列片段的质粒作为外参照品,采用TaqMan荧光探针检测技术,建立定量检测BKV DNA方法;并对112例肾移植术后患者,40例正常体检者的尿液和外周血标本BKV含量进行检测。结果:本研究建立的BKV实时荧光定量PCR检测方法灵敏度、特异度及重复性较好,定量PCR方法最低检测下限为8×102copy/ml,测量批内差异为0.54%~3.78%,批间差异为0.62%~4.58%。112例肾移植术后患者尿液和外周血BKV DNA的检测阳性率分别为27.7%和11.6%,BKV DNA阳性者尿液和外周血BKV中位数水平分别为8.2×104copy/ml和2.4×103copy/ml。40例正常人BKV尿液和外周血阳性率为2.5%和0%;与正常体检者相比,肾移植术后患者尿液及外周血BKVDNA阳性率及水平明显升高(P<0.01)。尿液BKV阳性率较外周血明显升高(P=0.02),但尿液和外周血中BKV含量无明显相关性。结论:实时荧光定量PCR检测... 目的:建立肾移植术后患者尿液和外周血BK病毒(BKV)感染负荷的实时荧光定量PCR检测方法,并初步探讨其临床应用价值。方法:构建含有BKV VP1蛋白保守区核苷酸序列片段的质粒作为外参照品,采用TaqMan荧光探针检测技术,建立定量检测BKV DNA方法;并对112例肾移植术后患者,40例正常体检者的尿液和外周血标本BKV含量进行检测。结果:本研究建立的BKV实时荧光定量PCR检测方法灵敏度、特异度及重复性较好,定量PCR方法最低检测下限为8×102copy/ml,测量批内差异为0.54%~3.78%,批间差异为0.62%~4.58%。112例肾移植术后患者尿液和外周血BKV DNA的检测阳性率分别为27.7%和11.6%,BKV DNA阳性者尿液和外周血BKV中位数水平分别为8.2×104copy/ml和2.4×103copy/ml。40例正常人BKV尿液和外周血阳性率为2.5%和0%;与正常体检者相比,肾移植术后患者尿液及外周血BKVDNA阳性率及水平明显升高(P<0.01)。尿液BKV阳性率较外周血明显升高(P=0.02),但尿液和外周血中BKV含量无明显相关性。结论:实时荧光定量PCR检测肾移植患者术后BKV感染方法简便、可靠、准确,为进一步研究BKV感染与肾移植术后移植物丢失的关系奠定了基础。
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