细胞毒素相关蛋白毒力型幽门螺杆菌感染与冠心病患者血清炎性因子及同型半胱氨酸水平的相关性研究  

Relationship Between Helicobacter Pylori Infection and Inflammatory Cytokines, Homocysteine in Patients With Coronary Artery Disease

作　　者：沈云峰[1] 胡远贵[1] 张洪波[1] 

机构地区：[1]武汉市第六医院检验科,湖北省430015

出　　处：《中国循环杂志》2015年第2期119-122,共4页Chinese Circulation Journal

基　　金：武汉市卫生局临床医学科研项目(编号:WX11B14)

摘　　要：目的：探讨幽门螺杆菌（HP）及细胞毒素相关蛋白毒力型HP（HP—CagA）感染对冠心病患者血清炎性因子及同型半胱氨酸（Hey冰平影响以及HP—CagA感染与冠心病的相关性。方法：应用酶联免疫吸附分析法测定105例冠心病患者（冠心病组）和76例同期住院非冠心病患者（对照组）的血清HP特异性IgG抗体及其CagA特异性IgG抗体；采用乳胶增强散射免疫比浊法测定血清高敏C反应蛋白（hs—CRP）；采用化学发光法测定血清中肿瘤坏死因子-α（TNF-Ⅱ）、白细胞介素一6（IL一6）和Hcy水平，并比较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HP—CagA—IgG阴性患者之间的差异。应用多元Logistic回归分析危险因素对冠心病的影响，用调整后的比值比（OR）和95％可信区间（CI）评估HP抗体阳性对患冠心病的危险性。结果：冠心病组与对照组HP—IgG抗体的阳性率分别为52.3％和35．5％，差异有统计学意义（P〈0．05）；冠心病组血清hs—CRP、TNF—α、IL一6和Hcy水平高于对照组，差异有统计学意义（P〈O．05）；冠心病组HP—IgG阳性患者中，HP—CagA—IgG阳性患者hs—CRP、TNF一仅、IL一6和Hcy血清浓度水平高于HP—CagA—IgG阴性患者（P均〈O．05）。应用Logistic多元回归分析，在排除其他传统因素后，HP—IgG阳性和HP—CagA—IgG阳性对患冠心病存在相对危险性（OR=2．278，3．297；95％CI：1．20～4．32，1．50～7．27；P=0．012，0．003）。结论：冠心病的发生可能与HP感染有关系，HP—CagA感染可能通过刺激机体产生更多的炎性因子和Hcy，加快冠心病的发生、发展，是冠心病的危险因素之一。Objective： To study the relationship between helicobacter pylori （HP） infection and inflammatory cytokines, homocysteine （Hcy） in patients with coronary artery disease （CAD）, and the relationship between cytotoxin associated protein A toxins of liP （HPCagA） and CAD occurrence. Methods： Our research included 2 groups： CAD group, n=105 and Control group, n=76 patients without CAD. The serum Hp-IgG antibody and HpCagA-IgG antibody were measured by ELISA. Blood levels of Hs-CRP, TNF-α, IL-6 and Hcy were examined and compared between 2 groups. The differences between CAD patients with HP infection and without HP infection were compared, and the differences between CAD patients with positive HPCagA-IgG and negative HPCagA-IgG were compared Logistic regression analysis was conducted to study the risk factors of CAD, the adjusted OR and 95% CI were used to evaluate the positive Hp for CAD risk. Results： The positive rate of HP-IgG in CAD group and Control group were 52.3% and 35.5%; compared with Control group, CAD group had the increased levels of Hs-CRP, TNF-α, IL-6 and Hcy; in CAD group, the patients with positive HP-IgG showed the higher levels of Hs-CRP, TNF-α, IL-6 and Hcy than those with negative HP-IgG, and the patients with positive HpCagA-IgG presented the higher levels of Hs-CRP, TNF-α, IL-6 and Hcy than those with negative HPCagA-IgG, all P〈0.05. Logistic regression analysis indicated that with adjusted traditional risk factors, the positive HP-IgG and positive HpCagA-IgG were the risk factors for CAD （OR=2.278, 95% CI 1.20-4.32, P=0.012 and OR=3.297, 95% CI 1.50-7.27, P=0.003）. Conclusion： HP infection might be related to CAD, and the patients with HP infection and positive HPCagA-IgG could have CAD occurrence and development.

关 键 词：幽门螺杆菌 细胞毒素相关蛋白A 冠心病 高敏C反应蛋白 肿瘤坏死因子-α 白细胞介素-6 同型半胱氨酸 

分 类 号：R54[医药卫生—心血管疾病]