血管性痴呆患者幽门螺杆菌感染和胰岛素抵抗的相关性研究  

Association between Hp infection and insulin resistance in vascular dementia patients

作　　者：罗科学[1] 边杰 

机构地区：[1]浙江省立同德医院干部保健科,杭州310012 [2]浙江大学医学院附属邵逸夫医院国际医疗中心

出　　处：《中华老年心脑血管病杂志》2017年第11期1142-1144,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨幽门螺杆菌(Hp)感染和胰岛素抵抗与血管性痴呆(VaD)的相关性。方法收集VaD患者86例(VaD组)及健康体检者52例(对照组),根据Hp感染情况,将VaD患者进一步分为2组,Hp阳性组50例,Hp阴性组36例。以13碳尿素呼气试验阳性作为Hp感染的诊断指标,分别检测空腹血糖、空腹胰岛素,根据自我平衡模型分析法计算胰岛素抵抗指数(HOMA-IR)。结果 VaD组Hp阳性率显著高于对照组(58.14%vs 28.58%,χ2=10.273,P=0.002)。与对照组比较,VaD组的空腹血糖[(5.53±0.60)mmol/L vs(5.19±0.38)mmol/L,P=0.0004]、空腹胰岛素[(10.29±4.95)μIU/L vs(8.77±4.02)μIU/L,P=0.0317]、HOMA-IR(2.57±1.34 vs2.06±0.96,P=0.0179)均明显升高。Hp阳性组空腹血糖、空腹胰岛素、HOMA-IR均显著高于Hp阴性组,差异有统计学意义(P<0.05,P<0.01)。结论 Hp感染和胰岛素抵抗都与VaD显著相关,且Hp感染和胰岛素抵抗密切相关,三者可能存在相互关联的发病链条,Hp感染可能通过诱发或加重胰岛素抵抗导致VaD产生或发展。Objective To study the association of Hp infection and insulin resistance（IR）with vascular dementia（VaD）.Methods Eighty-six elderly VaD patients admitted to our hospital from April 2015 to April 2016 served as a VaD group and 52 healthy subjects undergoing physical examination served as a control group in this study.The patients in VaD group were further divided into Hp-positive group（n=50）and Hp-negative group（n=36）.Their fasting blood glucose（FBG）and fasting insulin（FINS）levels were measured with positive C13 urea breath test as the diagnostic index of Hp infection.HOMA-IR=FINS×FBG/22.5 was calculated according to the self balance model analysis.Results The positive Hp rate,serum FBG and FINS levels,and HOMA-IR were significantly higher in VaD group than in control group（58.14%vs 28.58%,χ2=10.273,P=0.002;5.53±0.60 mmol/Lvs 5.19±0.38 mmol/L,P=0.0004;10.29±4.95μIU/L vs8.77±4.02μIU/L,P=0.0317;2.57±1.34 vs 2.06±0.96,P=0.0179）.The serum FBG and FINS levels and HOMA-IR were significantly higher in Hp-positive group than in Hp-negative group（P〈0.05,P〈0.01）.Conclusion Hp infection and IR are closely associated with VaD,and can thus lead to the occurrence or progression of VaD by inducing or aggravating IR.

关 键 词：痴呆 血管性 螺杆菌 幽门 胰岛素抗药性 冠心病 脑梗死 

分 类 号：R749.13[医药卫生—神经病学与精神病学]