CAJ | 학술논문

目的探讨一个新临床综合征的识别,包括咽炎、颈椎病、胸痛和心脏反应.方法收集2003-2005年于本院治疗的同时具有咽炎、颈椎病、胸痛和心脏反应等症状并被排除冠心病的患者165例,并收集85例健康体检者作为对照组.检测研究对象血清抗β1肾上腺素能受体抗体,抗心肌肌球蛋白重链抗体,抗M2胆碱能受体抗体,抗心肌细胞线粒体内膜ADP/ATP载体蛋白抗体及炎症因子、高敏C反应蛋白,血清柯萨奇B病毒、巨细胞病毒、肺炎支原体和肺炎衣原体抗体,并用流式细胞仪测定淋巴细胞分类.结果所有的患者有四联症或五联症:(1)持续的咽部及上呼吸道感染;(2)颈痛;(3)胸痛;(4)胸闷及呼吸困难,有时伴有焦虑.病例组心肌自身抗体阳性率为100%,而健康对照组为8%.病例组的肿瘤坏死因子a,白细胞介素1,白细胞介素6明显高于对照组(P＜0.01),病例组的总T淋巴细胞百分数和杀伤T淋巴细胞阳性百分数均明显高于对照组,而自然杀伤淋巴细胞明显低于对照组(P＜0.01).病例组的血清柯萨奇B病毒、巨细胞病毒、肺炎支原体和肺炎衣原体抗体阳性率明显增高.结论证据表明存在一种与呼吸道感染相关的临床综合征,包括咽部感染、颈椎病、肋软骨炎、胸闷及呼吸困难,伴有(或无)焦虑症状.
목적 탐토일개신림상종합정적식별,포괄인염、경추병、흉통화심장반응.방법 수집2003-2005년우본원치료적동시구유인염、경추병、흉통화심장반응등증상병피배제관심병적환자165례,병수집85례건강체검자작위대조조.검측연구대상혈청항β1신상선소능수체항체,항심기기구단백중련항체,항M2담감능수체항체,항심기세포선립체내막ADP/ATP재체단백항체급염증인자、고민C반응단백,혈청가살기B병독、거세포병독、폐염지원체화폐염의원체항체,병용류식세포의측정림파세포분류.결과 소유적환자유사련증혹오련증:(1)지속적인부급상호흡도감염;(2)경통;(3)흉통;(4)흉민급호흡곤난,유시반유초필.병례조심기자신항체양성솔위100%,이건강대조조위8%.병례조적종류배사인자a,백세포개소1,백세포개소6명현고우대조조(P＜0.01),병례조적총T림파세포백분수화살상T림파세포양성백분수균명현고우대조조,이자연살상림파세포명현저우대조조(P＜0.01).병례조적혈청가살기B병독、거세포병독、폐염지원체화폐염의원체항체양성솔명현증고.결론 증거표명존재일충여호흡도감염상관적림상종합정,포괄인부감염、경추병、륵연골염、흉민급호흡곤난,반유(혹무)초필증상.
Objective To analyze the characteristics of a new clinical syndrome,including throat infection,neck spinal disease,chest pain and cardiac response.Methods A total of 65 patients with above mentioned symptoms admitted to Tongii hospital from 2003 to 2005 were included in this study and underwent further medical history inquiry,physical examination and laboratory tests.Eighty-five healthy subjects served as controls.Serum myocardial auto-antibodies against beta1-adrenoceptor,alpha-myosin heavy chain,M_2-muscarinic receptor and adenine-nucleotide translocator were detected,inflammatory cytokines,high sensitivity C-reaction protein,serum antibodies against Coxsackie virus-B,cytomegalovirus,Mycoplasma pneumoniae and Chlamydia pneumoniae were determined and lymphocyte subelasses were assayed by flow cytometry.Results All patients had a complex of four symptoms or tetralogy:(1)persistent throat or upper respiratory tract infection;(2)neck pain;(3)chest pain;(4)chest depression or dyspnea,some of them with anxiety.Anti-myocardial auto-antibodies(AMCA)were present in all patients vs.8% in controls.TNF-a,IL-1 and IL-6 were significantly higher in patients than controls(P＜0.01).CD3~+ and CD4~-CD8~+ lymphocytes were significantly higher and CD56~+ lymphocytes lower in patients than those in controls(P＜0.01).The ratios of serum pathogen antibodies positive against Coxsackic virus-B,cytomegalovirus,Mycoplasma pneumoniae and Chlamydia pneumoniae were all significantly higher in patients than in controls.Conclusions These data led to identification of a persistent respiratory infectionrelated clinical syndrome,including persistent throat infection,neck spinal lesion,rib cartilage inflammation,symptoms of cardiac depression and dyspnea with or without anxiety.