幽门螺杆菌感染对颈动脉粥样硬化患者血清同型半胱氨酸水平的影响

doi:10.3969/j.issn.1673-8640.2015.09.007

摘要/Abstract

摘要： 目的

探讨幽门螺杆菌(Hp)感染对颈动脉粥样硬化患者颈动脉内膜中层厚度(CIMT)、斑块易损性以及同型半胱氨酸(Hcy)代谢的影响。

方法

选取行颈动脉彩超提示颈动脉粥样硬化的知情同意者129例,采用¹⁴C尿素呼气试验检测入选对象的Hp感染情况,同时采用循环酶法测定其血清Hcy水平。

结果

颈动脉粥样硬化患者中Hp感染者血清Hcy水平和CIMT高于Hp阴性者(P均<0.01),且随着患者体内Hp感染程度的加重,其血清Hcy水平及CIMT亦相应增高(P均<0.01)。Hp不同感染程度各组血清Hcy水平及CIMT差异均有统计学意义(P<0.01)。Hp感染组斑块检出率高于Hp阴性组(P<0.05),且Hp感染组易损斑块的发生率明显高于Hp阴性组(P<0.05)。Logistic回归分析显示,在斑块性颈动脉粥样硬化患者中,Hp感染者并发易损斑块可能性是Hp阴性者的2.35倍;血清Hcy每升高1 μmol/L,发生易损斑块的可能性增加9%。

结论

Hp感染可能通过影响Hcy代谢以及增加CIMT和颈动脉硬化斑块的不稳定性,促进动脉粥样硬化的发生和进展。

关键词: 同型半胱氨酸, 幽门螺杆菌, 颈动脉粥样硬化, 颈动脉斑块, 内中膜厚度

Abstract: Objective

To investigate the influence of Helicobacter pylori (Hp) infection on carotid intima-media thickness(CIMT), plaque stability and the metabolism of homocysteine(Hcy) in carotid atherosclerosis patients.

Methods

According to carotid artery ultrasonography, 129 patients with carotid atherosclerosis were enrolled. ¹⁴C urea breath test was used to determine Hp infection. Meanwhile, enzymatic cycling method was used to determine serum Hcy levels .

Results

Serum Hcy levels and CIMT of patients with carotid atherosclerosis in Hp infection group were higher than those in Hp non-infection group (P<0.01), and they increased with the severity of Hp infection with statistical significance (P<0.01). The plaque detection rate in Hp infection group was higher than that of Hp non-infection group(P<0.05), and the incidence of vulnerable plaques in Hp infection group was obviously higher than that in Hp non-infection group(P<0.05). Logistic regression analysis showed that the possibility of vulnerable plaques in Hp infection group was 2.35 times higher than that in Hp non-infection group. With serum Hcy increasing by 1 μmol/L, the possibility of vulnerable plaque increased by 9%.

Conclusions

Hp infection is likely to promote the development and progression of carotid atherosclerosis through influencing Hcy metabolism and increasing CIMT and the instability of carotid atherosclerotic plaque.

Key words: Homocysteine, Helicobacter pylori, Carotid atherosclerosis, Carotid artery plaque, Intima-media thickness

中图分类号:

R446.1

雷鸣, 白驹, 吴建华, 夏丹妮, 郑睿东. 幽门螺杆菌感染对颈动脉粥样硬化患者血清同型半胱氨酸水平的影响[J]. 检验医学, 2015, 30(9): 894-897.

LEI Ming, BAI Ju, WU Jianhua, XIA Danni, ZHENG Ruidong. The influence of Helicobacter pylori infection on serum homocysteine level in patients with carotid atherosclerosis[J]. Laboratory Medicine, 2015, 30(9): 894-897.

图/表 5

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组别	例数	年龄(岁)	男性(%)	经常吸烟(%)	肥胖(%)	高血压病(%)	糖尿病(%)	血脂异常(%)
Hp感染组	71	65±11	40(56.34)	35(49.29)	38(53.52)	43(60.56)	21(29.58)	41(57.75)
Hp阴性组	58	66±11	32(55.17)	30(51.72)	26(44.83)	34(58.62)	18(31.03)	28(48.28)
统计值		t=-0.627 0	χ²=0.017 6	χ²=0.075 3	χ²=0.965 1	χ²=0.500 7	χ²=0.032 13	χ²=1.151 0
P值		0.531 7	0.447 2	0.391 9	0.163 0	0.411 5	0.428 9	0.142 4

组别	例数	年龄(岁)	男性(%)	经常吸烟(%)	肥胖(%)	高血压病(%)	糖尿病(%)	血脂异常(%)
Hp感染组	71	65±11	40(56.34)	35(49.29)	38(53.52)	43(60.56)	21(29.58)	41(57.75)
Hp阴性组	58	66±11	32(55.17)	30(51.72)	26(44.83)	34(58.62)	18(31.03)	28(48.28)
统计值		t=-0.627 0	χ²=0.017 6	χ²=0.075 3	χ²=0.965 1	χ²=0.500 7	χ²=0.032 13	χ²=1.151 0
P值		0.531 7	0.447 2	0.391 9	0.163 0	0.411 5	0.428 9	0.142 4

组别	例数	Hcy(μmol/L)	CIMT(mm)
Hp阴性组	58	16.55±5.86	0.95±0.23
Hp轻度感染组	52	24.96±5.97	1.16±0.22
Hp重度感染组	19	30.27±6.21	1.28±0.25
F值		49.02	19.75
P值		<0.01	<0.01

组别	例数	Hcy(μmol/L)	CIMT(mm)
Hp阴性组	58	16.55±5.86	0.95±0.23
Hp轻度感染组	52	24.96±5.97	1.16±0.22
Hp重度感染组	19	30.27±6.21	1.28±0.25
F值		49.02	19.75
P值		<0.01	<0.01

组别	例数	是否有斑块		斑块类型
组别	例数	有	无	易损斑块	非易损斑块
Hp感染组	71	49(69.01)	22(30.99)	25(51.02)	24(48.98)
Hp阴性组	58	31(53.45)	27(46.55)	10(32.26)	21(67.74)