幽门螺杆菌感染对帕金森病合并糖尿病视网膜病变患者糖代谢和氧化应激及视网膜病变的影响  

Effects of Helicobacter pylori infection on glucose metabolism,oxidative stress and retinopathy in patients with Parkinson’s disease and diabetic retinopathy

作　　者：贺姣 薛兵 周玉霞[1] 杜公博 卢宏[1] HE Jiao;XUE Bing;ZHOU Yu-xia;DU Gong-bo;LU Hong(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第一附属医院神经内科,河南郑州450000

出　　处：《中华医院感染学杂志》2020年第3期409-413,共5页Chinese Journal of Nosocomiology

基　　金：河南省科研计划基金资助项目(2018682)。

摘　　要：目的探究帕金森病合并糖尿病视网膜病变患者幽门螺杆菌感染血清C肽水平及幽门螺杆菌抗体-IgG(Hp-IgG)。方法选择2016年1月-2018年12月郑州大学第一附属医院收治的帕金森病合并糖尿病视网膜病变患者62例为研究对象,根据Hp-IgG抗体类型分为I型组32例和Ⅱ型组11例及未感染组19例;检测三组患者丙二醛(MDA)含量、超氧化物歧化酶(SOD)水平、复合素I(Complex I)活性、血清C肽浓度,记录运动症状评分;行糖耐量试验检测空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c);并检测神经纤维层(RNFL)厚度、黄斑厚度、视野平均缺损深度(MD)。结果Hp抗体I型阳性检出率为51.61%(32/62)高于Hp抗体Ⅱ型17.74%(11/62);Hp-IgG抗体I型和Ⅱ型组患者FBG、2 h PBG、HbA1c、UPDRS III评分、UPDRS IV评分分别为(8.57±0.58)mmol/L、(16.11±3.54)mmol/L、(8.97±1.25)%、(26.84±7.29)分、(3.38±0.89)分和(8.61±0.49)mmol/L、(16.18±3.68)mmol/L、(8.93±1.30)%、(27.03±7.25)分、(3.29±0.91)分高于非Hp感染组(P<0.05);Hp-IgG抗体I型、Ⅱ型组的MDA高于非Hp感染组,而SOD、Complex I活性低于非Hp感染组(P<0.05);Hp-IgG抗体I型、Ⅱ型组的血清C肽水平为(1.42±0.71)ng/ml、(1.45±0.69)ng/ml低于非Hp感染组(P<0.05);Hp-IgG抗体I型组的黄斑厚度、RNFL厚度、MD值与II型差异无统计学意义;Hp-IgG抗体I型、Ⅱ型组的黄斑厚度为(263.87±7.56)μm,(264.19±7.92)μm、RNFL厚度(115.15±16.39)μm,(113.62±16.18)μm、MD值为(-5.30±1.53)dB,(-5.29±1.58)dB低于非Hp感染组(P<0.05)。结论帕金森病合并糖尿病视网膜病变患者的幽门螺杆菌感染率较高,Hp感染增强机体的氧化应激反应,损伤线粒体功能,加重运动并发症程度,不利于血糖水平控制,血清C肽水平降低,加剧视网膜病变。OBJECTIVE To investigate the effect of Helicobacter pylori infection on serum C-peptide levels and Hp-IgG antibody types in patients with Parkinson’s disease and diabetic retinopathy.METHODS A total of 62 patients with Parkinson’s disease and diabetic retinopathy admitted to the First Affiliated Hospital of Zhengzhou University from Jan.2016 to Dec.2018 were selected as study subjects.The subjects were divided into type I group(32 cases),Type II group(11 cases),and non-infection group(19 cases)according to the isotype of Hp-IgG antibody.Malondialdehyde(MDA)content,superoxide dismutase(SOD)level,Complex I activity,serum C peptide concentration were measured in three groups,and the motor symptom scores were recorded.Fasting blood glucose test(FBG),postprandial 2 h blood glucose(2 hPBG),glycosylated hemoglobin(HbA1 c)were measured by glucose tolerance test.The patient’s nerve fiber layer(RNFL)thickness,macular thickness,and visual field mean depth of defect(MD)were recorded.RESULTS The positive detection rate of type I Hp antibody was 51.61%(32/62),higher than that of type II Hp antibody(17.74%,11/62).The FBG,2 hPBG,HbA1 c,UPDRS III and UPDRS IV scores scores of patients in type I versus type II Hp-IgG antibody groups were(8.57±0.58)vs.(8.61±0.49)mmol/L,(16.11±3.54)vs.(16.18±3.68)mmol/L,(8.97±1.25)%vs.(8.93±1.30)%,(26.84±7.29),vs.(27.03±7.25)points(3.38±0.89)vs.(3.29±0.91)points,respectively,significantly higher than those of patients in non-Hp infection group(P<0.05).MDA of patients in type I and type II Hp-IgG antibody groups was significantly higher than that of patients in non-Hp infection group(P<0.05),while SOD and Complex I activity was significantly lower than those of patients in non-Hp infection group(P<0.05).The serum C-peptide levels of patients in type I and type II Hp-IgG antibody groups were(1.42±0.71)ng/ml and(1.45±0.69)ng/ml,respectively,significantly lower than those of patients in non-Hp infection group(P<0.05).There was no significant difference of macular thickness,RNFL thickne

关 键 词：幽门螺杆菌 帕金森病 糖尿病视网膜病变 血清C肽水平 氧化应激 

分 类 号：R378[医药卫生—病原生物学]