幽门螺杆菌感染及TERT基因多态性与脑梗死颈动脉粥样硬化的关联  

Correlation between Helicobacter pylori infection,TERT gene polymorphism and carotid atherosclerosis in patients with cerebral infarction

作　　者：韩旭东 梁志刚[2] 阎志慧 张惠龙[2] 张志丽 曲艺 HAN Xu-dong;LIANG Zhi-gang;YAN Zhi-hui;ZHANG Hui-long;ZHANG Zhi-li;QU Yi(Yantai Harbor Hospital,Yantai,Shandong 264012,China;不详)

机构地区：[1]烟台海港医院神经内科,山东烟台264012 [2]烟台毓璜顶医院神经内科,山东烟台264000 [3]烟台山医院神经内科,山东烟台264000

出　　处：《中华医院感染学杂志》2022年第22期3391-3396,共6页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划面上基金资助项目(2019WS0500)。

摘　　要：目的分析幽门螺杆菌(Hp)感染及端粒酶逆转录酶(TERT)基因多态性与脑梗死(CI)颈动脉粥样硬化(CAS)的关联。方法选择2017年1月-2021年5月在烟台海港医院神经内科接受诊治的61例CI患者为研究对象,根据颈动脉内-中膜厚度(IMT)分为四组:一般组(IMT<1.00 mm)16例、增厚组(IMT≥1.00 mm)12例、稳定组(局限性IMT≥1.50 mm,回声信号强)19例、不稳定组(局限性IMT≥1.50 mm,回声信号弱或混合型)14例,比较四组Hp感染情况、TERT基因多态性,并分析其与CAS之间的关系。结果一般组、增厚组、稳定组、不稳定组Hp阳性率依次为25.00%、58.33%、78.95%、78.57%,稳定组、不稳定组Hp阳性率高于一般组(P<0.05)。TERT基因rs2736100位点:四组TT、TG、GG基因型频率有统计学差异(P<0.05)。TERT基因rs2853676位点:四组GG、GA、AA基因型频率有统计学差异(P<0.05),且稳定组Hp阳性患者GA基因型频率高于同组Hp阴性与一般组Hp阳性(P<0.05)。Logistic回归分析显示,CI中Hp阳性、TERT基因rs2736100位点TG、GG型及rs2853676位点GA、AA型患者CAS危险度更高(P<0.05)。结论Hp感染、携带TERT基因rs2736100位点TG、GG基因型与rs2853676位点GA、AA基因型的CI患者更容易发生CAS。OBJECTIVE To observe the association of Helicobacter pylori(Hp)infection,telomerase reverse transcriptase(TERT)gene polymorphism with carotid atherosclerosis(CAS)in patients with cerebral infarction(CI).METHODS A total of 61 CI patients who were treated in neurology department of Yantai Harbor Hospital from Jan 2017 to May 2021 were recruited as the study objects and were divided into four groups according to carotid intima-media thickness(IMT):the general group with IMT less than 1.00 mm(16 cases),the thickening group with IMT no less than 1.00 mm(12 cases),the stable group with local IMT no less than 1.50 mm,strong echo signal(19 cases),the unstable group with local IMT no less than 1.50 mm,weak echo signal or mixed type(14 cases).The prevalence of Hp infection and TERT gene polymorphisms were compared among the four groups,and the association with CAS was analyzed.RESULTS The positive rate of Hp was 25.00%in the general group,58.33%in the thickening group,78.95%in the stable group,78.57%in the unstable group;the positive rate of Hp was higher in the stable group and the unstable group than in the general hospital(P<0.05).There were significant differences in the frequencies of TT,TG and GG genotypes at rs2736100 locus of TERT gene among the four groups(P<0.05).There were significant differences in the frequencies of GG,GA and AA genotypes at rs2853676 locus of TERT gerne among the four groups(P<0.05).In the stable group,the frequency of GA genotype of the Hp-positive patients was higher than that of the Hp-negative patients and the Hp-positive patients in the general group(P<0.05).Logistic regression analysis showed that the CIS patients with positive Hp,TG and GG genotypes at rs2736100 locus of TERT gene and GA and AA genotypes at rs2853676 locus were at higher risk of CAS(P<0.05).CONCLUSION The CI patients with Hp infection,TG and GG genotypes at TERT gene and GA and AA genotypes at rs2853676 locus are more likely to have CAS.

关 键 词：缺血性脑卒中 脑梗死 颈动脉粥样硬化 幽门螺杆菌 端粒酶逆转录酶 基因多态性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]