根除幽门螺杆菌对冠心病患者血脂及炎症水平的影响  

Effect of Helicobacter pylori eradication on blood lipid and inflammation level in patients with coronary heart disease

作　　者：谭俊晖 王晓元[1] 杜美玲[1] 张爱爱[1] 李飞星[1] 易梦阳 李方江[1] TAN Junhui;WANG Xiaoyuan;DU Meiling;ZHANG Aiai;LI Feixing;YI Mengyang;LI Fangjiang(the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,075000)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《实用临床医药杂志》2022年第24期112-115,共4页Journal of Clinical Medicine in Practice

基　　金：2021年度河北省医学科学研究课题(20211598)。

摘　　要：目的探讨抗幽门螺杆菌(Hp)治疗对冠心病(CHD)患者血脂及炎症水平的影响。方法将120例CHD患者分为CHD并Hp阴性组48例,CHD并Hp阳性未抗Hp治疗组(NAHp)32例及CHD并Hp阳性抗Hp治疗组(AHp)40例,其中AHp组包括Hp根除组(EHp)28例、Hp未根除组(NEHp)12例。所有患者给予CHD药物常规治疗,包含阿司匹林、阿托伐他汀等二级预防,Hp治疗采用14 d四联法。检测所有患者治疗前及治疗4周后血脂及炎症标志物水平。结果治疗前,与CHD并Hp阴性组比较,NAHp组和AHp组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、氧化型低密度脂蛋白(ox-LDL)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)水平显著升高(P<0.05);与治疗前比较,治疗后EHp组、NEHp组及NAHp组的TC、TG、LDL-C、ox-LDL、CRP、Hcy水平均显著降低(P<0.05);4周治疗后,与NEHp组比较,EHp组中TC、TG、LDL-C、ox-LDL、CRP、Hcy水平显著降低(P<0.05),而NAHp组无显著变化(P>0.05)。结论根除Hp治疗有助于改善CHD患者脂质异常和炎症反应,进一步优化控制CHD的危险因素。Objective To investigate the effect of anti-Helicobacter pylori(Hp)treatment on blood lipid and inflammation level in patients with coronary heart disease(CHD).Methods A total of 120 patients with CHD were divided into CHD with Hp negative group(n=48),CHD featured as Hp positive without anti-Hp treatment group(NAHp group,n=32),and CHD featured as Hp positive with anti-Hp treatment group(AHp group,n=40).Among AHp group,the patients were further divided into Hp eradication group(EHp group,n=28)and Hp without eradication group(NEHp group,n=12).All the patients were conducted with routine drug treatment for CHD,including aspirin,atorvastatin and other drugs for secondary prophylaxis,and Hp was treated with 14 d quadruple therapy.The levels of blood lipid and inflammatory markers were measured before treatment and after 4 weeks of treatment in all patients.Results Before treatment,the levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),oxidized low-density lipoprotein(ox-LDL),C reactive protein(CRP)and homocysteine(Hcy)in the NAHp group and the AHp group were significantly higher than those in the CHD with Hp negative group(P<0.05);after treatment,the levels of TC,TG,LDL-C,ox-LDL,CRP and Hcy in the EHp group,the NEHp group and the NAHp group decreased significantly when compared to those before treatment(P<0.05);after 4 weeks of treatment,the levels of TC,TG,LDL-C,ox-LDL,CRP and Hcy in the EHp group were significantly lower than those in the NEHp group(P<0.05),but the NAHp group showed no significant change in the indexes above(P>0.05).Conclusion Hp eradication therapy is helpful to improve lipid abnormalities and inflammatory response in patients with CHD,and further optimize the control of risk factors of CHD.

关 键 词：幽门螺杆菌 冠心病 血脂 炎症 C反应蛋白 

分 类 号：R573.6[医药卫生—消化系统] R543.3[医药卫生—内科学]