幽门螺杆菌感染与老年人颈动脉粥样硬化的关系研究  

Relationship between Helicobacter pylori infection and carotid atherosclerosis in the elderly

作　　者：蓝华 黄雪[2] 姜海行[2] 陈晖[2] 张君红[2] 刘莹[2] 井洁[2] Lan Hua;Huang Xue;Jiang Haixing;Chen Hui;Zhang Junhong;Liu Ying;Jing Jie(The First Clinical Medical College of Guangzi Medical University,Nanning 530021,China;Department of Geriatrics and Gastroenterology,the First Affiliated Hospital of Guangri Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一临床医学院,南宁530021 [2]广西医科大学第一附属医院老年病学消化内科,南宁530021

出　　处：《中华老年医学杂志》2020年第8期887-890,共4页Chinese Journal of Geriatrics

基　　金：国家自然科学基金(81660093)。

摘　　要：目的研究幽门螺杆菌(Hp)感染与老年人颈动脉粥样硬化(CAS)的关系,为老年人心脑血管疾病防治提供理论依据。方法回顾性研究,选取2015年10月至2019年1月于广西医科大学第一附属医院住院,同时行13C-尿素呼气试验(13C-UBT)、颈动脉彩色及二维多普勒超声检查的年龄≥60岁的老年患者287例,其中Hp感染组137例,非Hp感染组150例,分析两组患者CAS传统高危致病因素(年龄、性别、高血压、糖尿病、肥胖、吸烟、饮酒、血脂异常、高尿酸血症)、血液生化指标、颈动脉内中膜厚度(IMT)增加及颈动脉斑块检出率。结果 Hp感染组和非Hp感染组患者CAS传统高危致病因素比较差异均无统计学意义(均P>0.05)。Hp感染组高密度脂蛋白胆固醇(HDL-C)低于非Hp感染组,差异有统计学意义(P<0.05);两组患者白细胞、中性粒细胞、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸、空腹血糖、肌酐和尿酸差异均无统计学意义(均P>0.05)。Hp感染组和非Hp感染组颈动脉IMT增厚检出率分别为65.0%(89例)和48.7%(73例),Hp感染组颈动脉IMT增厚检出率高于非Hp感染组(P<0.01);Hp感染组和非Hp感染组颈动脉斑块检出率分别为76.6%(105例)和64.7%(97例),Hp感染组颈动脉斑块检出率高于非Hp感染组(P<0.05);Hp感染组和非Hp感染组颈动脉IMT增厚合并斑块检出率分别为56.2%(77例)和32.7%(49例),Hp感染组颈动脉IMT增厚合并斑块检出率高于非Hp感染组,差异有统计学意义(P<0.01)。结论 Hp感染可能通过引起脂类代谢异常促进老年人CAS的发生和发展,尽早对Hp感染的老年患者给予积极地干预和治疗,可能会降低CAS的发生率。Objective To investigate the relationship between Helicobacter pylori(Hp)infection and carotid atherosclerosis(CAS)in the elderly,in order to provide an empirical basis for the prevention and treatment of cardiovascular and cerebrovascular diseases in the elderly.Methods A total of 287 patients aged 60 years and over admitted to the First Affiliated Hospital of Guangxi Medical University,who underwent the 13C-urea breath test(13 C-UBT),carotid color and two-dimensional Doppler ultrasonography from October 2015 to January 2019,were retrospectively enrolled.Patients were divided into the Hp infection group(n=137)and the non-Hp infection group(n=150).Common high-risk pathogenic factors,blood biochemical indicators,carotid intima-media thickness(IMT)and detection rate of carotid plaque were compared between the two groups.Results Common high-risk pathogenic factors including age,gender,hypertension,diabetes,obesity,smoking,alcohol consumption,dyslipidemia,and hyperuricemia showed no significant difference between the two groups(P>0.05).The level of high-density lipoprotein cholesterol(HDL-C)was lower in the Hp infection group than in the non-Hp infection group(P<O.05).There was no difference in levels of white blood cells,neutrophils,total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),homocysteine,fasting blood glucose,creatinine or uric acid between the two groups(P>0.05).The detection rates of increased carotid IMT and carotid plaques were higher in the Hp infection group than in the non-Hp infection group(65.0%or 89 cases vs.48.7%or 73 cases,76.6%or 105 cases vs.64.7%or 97 cases,P<0.01 and 0.05).The detection rate of carotid plaques in the Hp-infected group was higher than that in the non-Hp-infected group(P<0.05).The combined detection rate of increased carotid IMT and plaques was higher in the Hp infection group than in the non-Hp infection group(56.2%or 77cases vs.32.7%or 49 cases P<0.01).Conclusions Hp infection may play a role in the occurrence and progression of carotid atheros

关 键 词：螺杆菌 幽门 颈动脉狭窄 脂蛋白类 HDL 

分 类 号：R543.4[医药卫生—心血管疾病]