幽门螺杆菌感染对颈动脉粥样硬化患者超声形态及血脂代谢的影响  

Effect of helicobacter pylori infection in ultrasound morphology and blood lipid metabolism in patients with carotid atherosclerosis

作　　者：雷鸣[1] 夏先考[1] 汤兰桂[1] 杨丽[2] 郑睿东 张洪鑫[1] 

机构地区：[1]常德市第一人民医院,湖南常德415003 [2]常德职业技术学院,湖南常德415003

出　　处：《现代预防医学》2014年第21期3990-3992,4001,共4页Modern Preventive Medicine

基　　金：湖南省医药卫生科研计划课题(B2013-146)

摘　　要：目的探讨颈动脉粥样硬化患者幽门螺杆菌(Helicobacter Pylori,HP)感染与颈动脉内中膜厚度、斑块稳定性以及血脂代谢的关系。方法选取2012年3月-2013年1月在我院行颈动脉彩超提示颈动脉粥样硬化的知情同意者206例,根据14C尿素呼气试验结果将所有受试者分为HP感染组和HP非感染组;同时根据颈动脉粥样硬化程度将HP感染患者分为IMT增厚组、稳定斑块组和不稳定斑块组。采用高分辨率超声测定颈总动脉(Common Carotid Arteries,CCA)、颈动脉分叉处(the bifurcation of carotid arteries,CB)及颈内动脉起始段(intemal carotid arteries,CCI)内中膜厚度(Intima-Media Thickness,IMT),观察颈动脉形态、斑块的有无及斑块的回声,并检测所有受试者血脂水平,分析Hp感染与颈动脉粥样硬化患者颈动脉内中膜厚度、斑块稳定性以及血脂代谢的关系。结果颈动脉粥样硬化患者HP感染组CCA-IMT、CB-IMT及CCI-IMT高于HP非感染组,差异均具有统计学意义(P<0.01),且两组间颈动脉粥样硬化类型的构成差异具有统计学意义(χ2=15.939,P=0.0003),在HP感染组中,不稳定性斑块占43.09%,而HP非感染组中,不稳定性斑块仅占26.51%;HP感染组血清TC、LDL、TG水平高于HP非感染组,差异均具有统计学意义(P<0.05,P<0.01);HP感染患者中不同颈动脉粥样硬化程度分组在TC、TG、HDL-C、LDL-C四个指标上的差异具有统计学意义(P<0.01)。结论幽门螺杆菌感染可能通过增加颈动脉内中膜的厚度和颈动脉粥样斑块的不稳定性从而促使脑梗死风险增加,且还可能通过影响机体脂质代谢促进颈动脉粥样硬化的发生和发展。Objective To explore relationship between helicobacter pylori （HP） infection and carotid artery intima-media thickness, plaque stability, and also relationship between HP infection and blood lipid metabolism in atherosclerosis patients. Methods A total number of 206 patients diagnosed with carotid atherosclerosis using carotid uhrasonography, from March 2012 to January 2013, were admitted. According to the results of 14C urea breath test all the subjects were divided into HP infection group and non-HP infection group. The HP infection group was further divided into IMT thickening group, stable plaque group and unstable plaque group according to the degree of carotid artery atherosclerosis. Using high-resolution ultrasound, all the patients were measured the intima-media thickness （IMT） of the common carotid arteries （CCA）, the bifurcation of carotid arteries （CB） and the internal carotid arteries （CCI）, while the carotid artery morphology and the echo of the plaques were observed. And all the patients were tested the levels of blood lipid at the same time. Analysis of relationship was made between HP infection and carotid intima-media thickness, HP infection and plaque stability in patients with carotid atherosclerosis, as well as between HP infection and blood lipid metabolism. Results In carotid artery atheroscterosis patients with HP infection, CCA IMT, CB - IMT and CCI - IMT were all higher than in patients without HP infection, and differences between the two groups were statistically significant （P〈0.01）. And between the two groups carotid atherosclerosis types constituted a statistically significant difference （x2= 15.939, P=0.0003）. Unstable plaque accounted for 43.09% in HP infection group but only 26.51% in non-HP infection group. Serum TC, LDL, TG levels were statistically higher in HP infection group than in non-HP infection group. Differences between the subgroups with different degree of carotid artery atherosclerosis of HP infection patients were statistically signific

关 键 词：幽门螺杆菌 颈动脉粥样硬化 颈动脉斑块 内中膜厚度 血脂 

分 类 号：R181.38[医药卫生—流行病学]