幽门螺杆菌感染对2型糖尿病患者慢性并发症的影响  

Effect of Helicobacter pylori infection on chronic complications in patients with type 2 diabetes

作　　者：田利华 薛亚男[2] 涂强 徐秀盈 Tian Lihua;Xue Yanan;Tu Qiang;Xu Xiuying(Department of Medicine,Qinhuangdao Jungong Hospital,Qinhuangdao 066000,China;Department ofEendocrinology,Hospital of Hebei Port Group Company Limited,Qinhuangdao 066000,China;Unit of Comprehensive Psychiatric Nursing,Zhengding Courtyard of Joint Logistics Support Force980 Hospital,Shijiazhuang 050800,China)

机构地区：[1]秦皇岛军工医院综合内科,河北秦皇岛066000 [2]河北港口集团有限公司港口医院内分泌科,河北秦皇岛066000 [3]联勤保障部队第980医院正定院区综合精神护理单元,河北石家庄050800

出　　处：《临床荟萃》2019年第5期436-440,共5页Clinical Focus

摘　　要：目的评价幽门螺旋杆菌(H.pylori)感染对2型糖尿病(T2DM)患者慢性并发症的影响。方法2016年5月至2017年6月我院内分泌科住院的T2DM患者179例,根据13C呼气试验检测H.pylori结果分为两组,H.pylori阳性(H.pylori+)组108例,H.pylori阴性(H.pylori-)组71例;比较两组患者的糖尿病相关指标。结果T2DM患者中H.pylori感染率为60.3%。两组之间年龄、体重指数、糖尿病病程、血压、空腹血糖、糖化血红蛋白、空腹胰岛素(未使用胰岛素降糖者)、空腹C肽、天冬氨酸转氨酶、丙氨酸转氨酶、甘油三酯、高密度脂蛋白胆固醇、血尿酸、肌酐、是否使用胰岛素降糖治疗之间差异无统计学意义(P>0.05);与H.pylori-组比较,H.pylori+组患者中有糖尿病家族史的比率较高(P<0.01),男性患者较多(P<0.01)以及较高水平的总胆固醇(P<0.05)和低密度脂蛋白胆固醇(P<0.05);H.pylori+组患者的糖尿病慢性微血管、大血管并发症发生率均高于H.pylori-组(P<0.01),非酒精性脂肪肝的比率增加(P<0.05)。结论H.pylori感染对T2DM患者的糖尿病慢性并发症存在影响,应积极推荐在T2DM患者中筛查和根除H.pylori。Objective To evaluate the association between Helicobacter pylori ( H.pylori ) infection and type 2 diabetes mellitus (T2DM).MethodsA total of 179 T2DM patients from our hospital were divided into H.pylori positive( n =108) and H.pylori negative( n =71) groups according to 13 C-urea breath test.At baseline,we performed blood tests including fasting glucose,fasting insulin,glycated haemoglobin A 1c (HbA 1c) and other biochemical measurements.ResultsThe prevalence of H.pylori infection was 60.3% in diabetic patients.There was no significant difference between two groups in age,body mass index,the duration of diabetes,SBP,DBP,fasting glucose,HbA 1c,fasting insulin,fasting C peptide,ALT,AST,TG,HDL-C,UA,CRE,Whether or not insulin used ( P > 0.05 ).In T2DM patients,the males and those who had the family history of diabetes had a higher rate of H.pylori infection ( P < 0.01 ).There were significant differences in TC and LDL-C ( P < 0.05 ).T2DM patients with H.pylori infection had a higher risk of the occurrence of diabetic chronic complications including,coronary atherosclerotic cardiopathy,cerebrovascular disease than those without H.pylori infection ( P < 0.01 ).And the rate of nonalcoholic fatty liver disease was higher in the patients with H.pylori infection ( P < 0.05 ).ConclusionThis study showed a higher prevalence of H.pylori infection in diabetic patients,and H.pylori infection may affect the development of diabetes chronic complications.Proper screening for H.pylori infection and H.pylori eradication therapies in diabetes patients should be recommended.

关 键 词：螺杆菌 幽门 感染 糖尿病 2型 

分 类 号：R587.1[医药卫生—内分泌]