Hp感染对高血压患者颈动脉粥样硬化的影响及ITGA1基因多态性特征  

Effect of Hp infection on carotid atherosclerosis in hypertensive patients and its correlation with ITGA1 gene polymorphisms

作　　者：巩江华 王勇 何新霞 薛燕 孟茹 GONG Jiang-hua;WANG Yong;HE Xin-xia;XUE Yan;MENG Ru(Hengshui People's Hospital,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市人民医院全科医学科,河北衡水053000 [2]衡水市人民医院腺体和血管外科,河北衡水053000 [3]衡水市人民医院检验科,河北衡水053000

出　　处：《中华医院感染学杂志》2023年第7期1050-1054,共5页Chinese Journal of Nosocomiology

基　　金：河北省卫健委计划基金资助项目(20181579)。

摘　　要：目的探究高血压患者幽门螺杆菌(Hp)感染对颈动脉粥样硬化(CAS)影响及与整联蛋白α亚基1(ITGA1)基因多态性的关联性。方法选取2019年1月-2021年9月衡水市人民医院118例高血压住院患者,根据Hp14C呼气试验结果分为感染组(n=71)和对照组(n=47)。比较两组患者血压、血脂、ITGA1基因多态性、颈动脉内膜中层厚度(IMT)、CAS发生率及严重程度,采用Sanger双脱氧链终止法对ITGA1基因(rs2447867位点)进行基因检测分型,采用多因素Logistic回归分析探究颈动脉粥样硬化影响因素。结果感染组患者收缩压、舒张压及血清甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均高于对照组(P<0.05);感染组患者IMT、CAS发生率及严重程度均高于对照组(P<0.05);感染组患者ITGA1基因rs2447867位点CC基因型及C等位基因频率高于对照组,TT基因型及T等位基因低于对照组(P<0.05);与Hp感染阴性者比,Hp感染阳性者CAS风险升高(OR=2.375,95%CI 1.148~4.914),与ITGA1 CC基因型相比,TT基因型者CAS风险下降(OR=0.406,95%CI 0.180~0.915)。结论合并Hp感染可能引起高血压患者血压升高、血脂代谢紊乱,增加CAS发生率及严重程度,而ITGA1基因rs2447867位点基因多态性与Hp感染易感性有关,携带TT基因型可能降低CAS风险。OBJECTIVE To explore the effect of Helicobacter pylori(Hp)infection on carotid atherosclerosis(CAS)in patients with hypertension and the association with integrinα-subunit 1(ITGA1)gene polymorphism.METHODS A total of 118 hospitalized patients with hypertension in Hengshui People′s Hospital between Jan 2019 and Sep 2021were enrolled,and were divided into the infection group(n=71)and control group(n=47)based on the results of Hp~(14)C breath test.The blood pressure,blood lipids,ITGA1 gene polymorphism,carotid intima-media thickness(IMT)and incidence rate and severity of CAS were compared between the two groups of patients.Sanger dideoxy chain termination method was used for ITGA1 gene(rs2447867 locus)genotyping,and multivariate Logistic regression analysis was used to explore the influencing factors for carotid atherosclerosis.RESULTS The systolic blood pressure,diastolic blood pressure,serum triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in the infection group were higher than those in the control group(P<0.05).The IMT and the incidence rate and severity of CAS in the infection group were higher than those in the control group(P<0.05).The frequencies of CC genotype and C allele at rs2447867 locus of ITGA1 gene in the infection group were higher than those in the control group while the frequencies of TT genotype and T allele were lower than those in th control group(P<0.05).Compared with patients with negative Hp infection,the risk for CAS in patients with positive Hp infection was higher(OR=2.375,95%CI 1.148-4.914).Patients carrying TT genotype had lower risk for CAS than patients carrying CC genotype of ITGA1 gene(OR=0.406,95%CI 0.180-0.915).CONCLUSION Combination of Hp infection may cause increased blood pressure and lipid metabolism disorders in hypertensive patients,leading the higher incidence and severity of CAS.And rs2447867 locus polymorphism of ITGA1 gene is related to the susceptibility of Hp infection.Patients carrying TT genotype may have less risk for CAS.

关 键 词：高血压 颈动脉粥样硬化 幽门螺杆菌 整联蛋白 基因多态性 

分 类 号：R544.1[医药卫生—心血管疾病]