幽门螺旋杆菌感染与颈动脉粥样硬化狭窄程度的关系  

Research on Association Between Helicobacter Pylori Infection and Different Degree of Carotid Atherosclerotic Stenosis

作　　者：赵红[1] 楚叶萌 王苏平[1] 赵红玲[1] 刘赞华[1] 蔺建文[1] 

机构地区：[1]大连市中心医院神经内科,辽宁省大连市116033 [2]北京顺义区医院神经内科,北京市101300

出　　处：《中国动脉硬化杂志》2016年第6期620-624,共5页Chinese Journal of Arteriosclerosis

摘　　要：目的观察不同程度颈动脉粥样硬化病变中幽门螺旋杆菌（Hp）感染情况,检测血清中脂蛋白相关磷脂酶A2（Lp-PLA_2）和基质金属蛋白酶9（MMP-9）的水平,分析Hp感染与颈动脉粥样硬化之间的关系,探讨Hp感染导致颈动脉狭窄的可能机制。方法选择2012年9月至2013年9月我院经颈动脉超声检查证实为颈动脉粥样硬化病人128例,分为重度狭窄组（狭窄率≥70%至接近闭塞;n=48）、中度狭窄组（狭窄率50%~69%;n=45）和轻度狭窄组（狭窄率〈50%;n=35）。另设颈动脉正常者作为对照组（n=20）。用酶联免疫吸附测定法检测血清中Hp抗体（Hp-IgG）及Lp-PLA_2、MMP-9的水平。结果 （1）颈动脉粥样硬化病人Hp-IgG阳性率64.1%,对照组为30.0%,颈动脉粥样硬化病人明显高于对照组（P〈0.05）;其中重度狭窄组Hp-IgG阳性率为75.0%,中度狭窄组为62.2%,轻度狭窄组为51.4%,均明显高于对照组（P〈0.05）。（2）Hp-IgG阳性组血清Lp-PLA_2和MMP-9浓度明显高于Hp-IgG阴性组（P〈0.05）。（3）重度狭窄组、中度狭窄组和轻度狭窄组Lp-PLA_2和MMP-9的浓度均明显高于对照组（P〈0.05）。结论 （1）Hp感染能增加患颈动脉粥样硬化的危险性,Hp感染程度加重,颈动脉狭窄有加重趋势。（2）Hp感染后可能通过升高炎症因子Lp-PLA_2、MMP-9,增强局部炎症反应来促进和加重颈动脉粥样硬化狭窄。Aim To observe Helicobacter pylori（Hp）infection situation in patients with different degree of carotid atherosclerotic stenosis,and to examine the level of serum lipoprotein-associated phospholipase A2（Lp-PLA_2）and matrix metalloproteinase-9（MMP-9）;To analyze the relationship between Hp infection and carotid atherosclerosis,and to explore possible mechanism of carotid atherosclerosis caused by infection. Methods From September 2012 to September 2013 in our hospital,a total of 128 patients with carotid atherosclerosis confirmed by carotid artery ultrasound was analyzed. The carotid artery stenosis patients were divided into three groups：severe stenosis group（stenosis rate≥70% to nearly occlusion;n = 48）,moderate stenosis group（stenosis rate 50% ~ 69%;n = 45）,mild stenosis group（stenosis rate50%;n = 35）. Normal carotid artery individuals were as a control group（n = 20）. Serum Hp antibody（Hp-IgG）,Lp-PLA_2,and MMP-9 levels were examined by enzyme-linked immunosorbent assay（ELISA）. Results（1）Hp-IgG positive rate was significantly higher in patients with carotid atherosclerosis than that in the control group（64. 1% vs30. 0%,P〈0. 05）. Hp-IgG positive rate was 75. 0% in severe stenosis group,62. 2% in moderate stenosis group,and51. 4% in mild stenosis group,which was significantly higher than that in control group（P〈0. 05）.（2）The serum concentrations of Lp-PLA_2 and MMP-9 in Hp-IgG positive group were significantly higher than those in Hp-IgG negative group（P〈0. 05）.（3）The serum concentrations of Lp-PLA_2 and MMP-9 in severe,moderate and mild stenosis groups were significantly higher than those in control group（P〈0. 05）. Conclusions（1）Hp infection can increase the risk of carotid atherosclerosis. With the aggravation of Hp infection,carotid stenosis has a tendency to increase.（2）Hp infection may enhance the local inflammatory response to promote and aggravate carotid atherosclerotic stenosis through the increase of inflammatory cytokines

关 键 词：颈动脉粥样硬化 幽门螺旋杆菌 脂蛋白相关磷脂酶A_2 基质金属蛋白酶9 

分 类 号：R5[医药卫生—内科学]