CagA-IgG阳性胃幽门螺杆菌感染对妊娠期糖尿病孕妇糖脂代谢的影响  

Impact of CagA-IgG-positive gastric Helicobacter pylori infection on glucose-lipid metabolism of pregnant women with gestational diabetes mellitus

作　　者：杨宇璇[1] 任斌 刘亚东 杨文文 彭妙清 王宝林[5] YANG Yu-xuan;REN Bin;LIU Ya-dong;YANG Wen-wen;PENG Miao-qing;WANG Bao-lin(Lanzhou Maternal and Child Health Hospital,Lanzhou,Gansu 730030,China;不详)

机构地区：[1]兰州市妇幼保健院内科,甘肃兰州730030 [2]兰州泽爱体检中心内科,甘肃兰州730030 [3]兰州市妇幼保健院疼痛科,甘肃兰州730030 [4]兰州市妇幼保健院病案室,甘肃兰州730030 [5]甘肃省妇幼保健院小儿消化感染科,甘肃兰州730000

出　　处：《中华医院感染学杂志》2021年第1期148-151,共4页Chinese Journal of Nosocomiology

基　　金：甘肃省科研基金资助项目(2017367)。

摘　　要：目的分析胃幽门螺杆菌(Hp)细胞毒素相关蛋白A(CagA)IgG抗体阳性对妊娠期糖尿病(GDM)孕妇糖脂代谢、体质量增长及孕吐症状的影响。方法选取兰州市妇幼保健院2016年1月-2018年12月进行系统产检且资料完整的200例GDM合并胃Hp(+)孕妇为研究对象,依据CagA-IgG检测实验,分为CagA-IgG阳性组和CagA-IgG阴性组,比较两组孕妇糖脂代谢指标、体质量增加量、孕吐症状及母婴并发症情况。结果 200例孕妇中共检测出87例CagA-IgG阳性,CagA-IgG阳性组孕妇的空腹血糖、餐后2 h血糖、胰岛素抵抗指数均高于CagA-IgG阴性组,空腹胰岛素低于CagA-IgG阴性组(P<0.05);CagA-IgG阳性组孕妇的总胆固醇、甘油三脂、低密度脂蛋白胆固醇均高于CagA-IgG阴性组(均P<0.05);CagA-IgG阳性组孕妇的体质量增加量、血清胃动素水平均低于CagA-IgG阴性组,孕吐次数及孕吐强度均显著高于CagA-IgG阴性组(P<0.05);CagA-IgG阳性组孕妇的手术生产、先兆子痫、产后出血、新生儿窘迫、巨大儿、低体质量儿发生率均高于CagA-IgG阴性组(P<0.05)。结论 Hp(+)CagA-IgG阳性会加重GDM孕妇糖脂代谢紊乱及孕吐症状,不利于孕期体质量增长,还会增加母婴并发症发生率。OBJECTIVE To observe the impact of cytotoxin-associated protein A(CagA)-IgG-positive gastric Helicobacter pylori on glucose-lipid metabolism,weight gain and morning sickness of pregnant women with gestational diabetes mellitus(GDM).METHODS From Jan 2016 to Dec 2018,a total of 200 GDM pregnant women with gastric Hp(+)who underwent systematic prenatal checkup and had complete data were recruited as the study objects and were divided into the CagA-IgG-positive group and CagA-IgG-negative group according to results of test of CagA-IgG.The glucose metabolism indexes,lipid metabolism indexes,increment of body mass,morning sickness and maternal and neonatal complications were compared between the two groups of pregnant women.RESULTS Of the 200 pregnant women,87 were tested positive for CagA-IgG.Fasting blood glucose(FBG),postprandial 2 h FBG(2 h FBG)and homeostasis model assessment of insulin resistance(HOMA-IR)of the CagA-IgG-positive group were significantly higher than those of the CagA-IgG-negative group,while fasting insulin(FINS)of the CagA-IgG-positive group was significantly lower than that of the CagA-IgG-negative group(P<0.05).The total cholesterol(TC),triacylglycerol(TG)and low-density lipoprotein cholesterol(LDL-C)of the CagA-IgG-positive group were significantly higher than those of the CagA-IgG-negative group(P<0.05).The increment of body mass and level of serum motilin of the CagA-IgG-positive group were significantly lower than those of the CagA-IgG-negative group,while number of times and strength of morning sickness were significantly higher in the CagA-IgG-positive group than in the CagA-IgG-negative group(P<0.05).The incidence rates of cesarean,preeclampsia,postpartum hemorrhage,neonatal distress,fetal macrosomia and low birth weight were higher in the CagA-IgG-positive group than in the CagA-IgG-negative group(P<0.05).CONCLUSION Hp(+)CagA-IgG+can aggravate the disorder of glucose-lipid metabolism and morning sickness of the pregnant women with GDM,which is not conducive to the weight gain during pre

关 键 词：妊娠期糖尿病 幽门螺杆菌 细胞毒素相关蛋白 孕吐 母婴结局 

分 类 号：R378[医药卫生—病原生物学]