冠心病患者幽门螺杆菌感染与血清MMP-9水平及冠状动脉病变的相关性  

Correlation between helicobacter pylori infection,serum MMP-9 level and coronary lesion in patients with coronary heart disease

作　　者：唐艳[1] 邓苏辛 张智亮[3] TANG Yan;DENG Suxin;ZHANG Zhiliang(Department of Cardiology,The First Affiliated Hospital of University of South China,Hengyang,Hunan 421001,China;Department of Cardiology,Hengyang Central Hospital,Hengyang ,Hunan 421001,China;Department of Cardiology, The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 530006,China)

机构地区：[1]南华大学附属第一医院心内科,湖南省衡阳市421001 [2]衡阳市中心医院心内科,湖南省衡阳市421001 [3]南昌大学第一附属医院心内科,江西省南昌市330006

出　　处：《中国动脉硬化杂志》2018年第12期1259-1265,共7页Chinese Journal of Arteriosclerosis

基　　金：江西省科技支撑计划项目(2009BSB11211)

摘　　要：目的探讨幽门螺杆菌(HP)和细胞毒素相关蛋白毒力型HP(HP-CagA)感染对冠心病患者血清基质金属蛋白酶9(MMP-9)水平的影响以及HP-CagA感染与冠心病冠状动脉病变的相关性。方法选择冠心病患者105例,其中急性心肌梗死(AMI)35例,不稳定型心绞痛(UAP)35例,稳定型心绞痛(SAP组)35例,选择同期住院非冠心病(NCA)患者35例,应用酶联免疫吸附法检测血清HP特异性IgG抗体阳性率、CagA特异性IgG抗体阳性率及MMP-9水平,并与冠状动脉造影Gensini评分进行相关性分析。比较HP感染的冠心病患者与非HP感染患者之间的差异,以及HP-CagA-IgG阳性患者与阴性患者之间的差异。结果各组血清MMP-9水平差异有统计学意义,其中AMI组>UAP组>SAP组>NCA组(P均<0.05);与NCA组比较,AMI组、UAP组及SAP组Gensini评分均增大(P均<0.05);各组血清MMP-9水平与Gensini评分之间有明显的相关性(P均<0.05)。SAP组、UAP组、AMI组及NCA组HP-IgG抗体的阳性率分别为40.0%、57.1%、74.3%和28.6%,其中AMI组>UAP组>SAP组>NCA组(P均<0.05);各组HP-IgG阳性患者的MMP-9水平均高于HP-IgG阴性患者(P均<0.05);各组血清HP-IgG抗体的阳性率与Gensini评分之间有明显的相关性(P均<0.05);SAP组、UAP组、AMI组及NCA组HP-CagA-IgG抗体的阳性率分别为17.1%、31.4%、40.0%和11.4%,其中AMI组>UAP组>SAP组>NCA组(P均<0.05);各组HP-CagA-IgG阳性患者的MMP-9水平均高于HP-CagA-IgG阴性患者(P均<0.05);各组血清HP-CagA-IgG抗体的阳性率与Gensini评分之间有明显的相关性(P均<0.05);其中血清MMP-9水平在HP-IgG(+)CagA-IgG(+)亚组>HP-IgG(+)CagAIgG(-)亚组>HP-IgG(-)CagA-IgG(+)亚组(P均<0.05);血清HP-IgG抗体的阳性率及血清HP-CagA-IgG抗体的阳性率均与血清MMP-9水平及Gensini评分之间有明显的相关性,尤其以血清HP-CagA-IgG抗体的阳性率与血清MMP-9水平及Gensini评分之间关系最密切(均P<0.05)。结论冠心病的发生发展可能与HP感染,尤其与HPCagA感染有关,其可能�Aim To investigate the impact of helicobacter pylori ( HP) infection and cytotoxin associated protein A toxin of HP ( HP-CagA) on serum matrix metalloproteinase-9 ( MMP-9) in patients with coronary heart disease ( CHD) , and the relationship between HP-CagA and coronary lesion. Methods 105 patients with CHD were chosen in this trial, including 35 patients with acute myocardial infarction ( AMI) ,35 patients with unstable angina pectoris ( UAP) and stable angina pectoris ( SAP) ,while 35 inpatients with normal coronary artery ( NCA) in the same period. The level of serum MMP-9,the positive rate of HP-IgG antibody and HP-CagA-IgG antibody were measured by enzyme-linked immunosorbent assay ( ELISA) and the correlation between the level of serum MMP-9,the positive rate of HP-IgG antibody,the positive rate of HP-CagA-IgG antibody and coronary angiography Gensini score were analyzed respectively. The differences between CHD patients with HP infection and without HP infection were compared,and the differences between CHD patients with positive HP-CagA-IgG and negative HP-CagA-IgG were compared. Results The four groups showed significant differences in serum MMP-9 level ( all P<0.05) ,among them,AMI group>UAP group>SAP group>NCA group ( all P <0.05) . Compared to NCA group,AMI group,UAP group and SAP group were higher in Gensini score ( all P<0.05) . There was significant correlation between serum MMP-9 level and Gensini score in each group ( all P<0.05) . The positive rates of HP-IgG in SAP group,UA group,AMI group and NCA group were 40%,57.1%,74.3% and 28.6%,respectively; among them,AMI group>UAP group>SAP group>NCA group ( all P<0.05) ; the patients with positive HP-IgG in each group showed the higher levels of MMP-9 than those with negative HP-IgG ( all P<0.05) ; there was significant correlation between the positive rate of serum HP-IgG and Gensini score in each group ( all P<0.05) . The positive rates of HP-CagAIgG in SAP group,UAP group,AMI group and NCA group were 17.1%,31.4%,40.0% and 11.4%,respectively; among t

关 键 词：幽门螺杆菌 细胞毒素相关蛋白A 冠心病 基质金属蛋白酶9 

分 类 号：R5[医药卫生—内科学]