健康体检人群幽门螺杆菌感染与颈动脉粥样硬化相关性分析  

Correlation between Helicobacter pylori infection and carotid atherosclerosis in people with physical examinations

作　　者：杨玉环 苏石 李鑫 张明明 王军[1] 马茂[1] Yang Yuhuan*;Su Shi;Li Xin;Zhang Mingming;Wang Jun;Ma Mao(Department of Health Medicine,First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;不详)

机构地区：[1]西安交通大学第一附属医院健康医学科,西安710061

出　　处：《中国循证心血管医学杂志》2023年第10期1208-1211,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：陕西省自然科学基金青年项目(2019SF-026)。

摘　　要：目的评估健康体检人群颈动脉粥样硬化与幽门螺杆菌感染之间的关系。方法选择2015年1月至2022年10月于西安交通大学第一附属医院健康医学科同时进行幽门螺杆菌检测和颈动脉超声检查的受检者36527例,分为颈动脉粥样硬化组(16436例)和无颈动脉粥样硬化组(20091例)。采用单因素和多因素Logistic回归分析颈动脉粥样硬化与幽门螺杆菌感染之间的相关性。并且对1021例患者进行了一个长达5~7年的随访,对颈动脉粥样硬化的发展进行分析。结果颈动脉粥样硬化组的幽门螺杆菌感染率(32.4%)显著高于无颈动脉粥样硬化组(30.3%,P<0.001)。颈动脉粥样硬化组的男性、年龄、高血压、糖尿病、血脂异常、体质指数(BMI)、谷草转氨酶(AST)、尿酸(UA)、空腹血糖(FBG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)水平均较高,白蛋白(ALB)、高密度脂蛋白胆固醇(HDL-C)水平均较低,差异有统计学意义(P<0.05)。多因素Logistic回归显示幽门螺杆菌感染(OR=1.087,95%CI:1.030~1.147,P=0.003)、年龄(OR=1.007,95%CI:1.003~1.110,P<0.001)、男性(OR=1.804,95%CI:1.650~1.972,P<0.001)、BMI(OR=0.973,95%CI:0.963~0.982,P<0.001)、高尿酸血症(OR=1.001,95%CI:1.001~1.002,P<0.001)、高血压(OR=1.193,95%CI:1.105~1.288,P<0.001)、糖尿病(OR=1.510,95%CI:1.304~1.748,P<0.001)与颈动脉粥样硬化相关。在进行5~7年的随访后发现,幽门螺杆菌持续阳性患者发生颈动脉粥样硬化的发生率高于持续未感染者(68.8%vs.59.7%,P=0.005)。结论幽门螺杆菌感染与颈动脉粥样硬化相关,幽门螺杆菌感染可能促进心血管疾病的发生。Objective To discuss the relationship between carotid atherosclerosis(CAS)and infection of Helicobacter pylori(HP)in people with physical examinations.Methods The cases(n=36527)with HP detection and carotid artery ultrasound examination were chosen from Department of Health Medicine in the First Affiliated Hospital of Xi`an Jiaotong University from Jan.2015 to Oct.2022.All patients were divided into CAS group(n=16436)and non-CAS group(n=20091).The correlation between CAS and HP infection was analyzed by using single-factor and multi-factor Logistic regression analysis.There were 1021 cases followed up for 5 y to 7 y and CAS development was analyzed.Results The infection rate of HP was 32.4%in CAS group and 30.3%in non-CAS group(P<0.001).The male cases,age,percentages of hypertension,diabetes and dyslipidemia,body mass index(BMI),and levels of aspertate aminotransferase(AST),uric acid(UA),fasting blood glucose(FBG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),triglyceride(TG)and albumin(ALB)were higher,and level of high-density lipoprotein-cholesterol(HDL-C)was lower in CAS group than those in non-CAS group(P<0.05).The results of multi-factor Logistic regression analysis showed that HP infection(OR=1.087,95%CI:1.030~1.147,P=0.003),age(OR=1.007,95%CI:1.003~1.110,P<0.001),male(OR=1.804,95%CI:1.650-1.972,P<0.001),BMI(OR=0.973,95%CI:0.963-0.982,P<0.001),hyperuricacidemia(OR=1.001,95%CI:1.001~1.002,P<0.001),hypertension(OR=1.193,95%CI:1.105~1.288,P<0.001)and diabetes(OR=1.510,95%CI:1.304~1.748,P<0.001)all were correlated to CAS.After 5y or 7y follow-up,ACS incidence rate was higher in cases with persistent HP positive than that in cases without HP infection(68.8%vs.59.7%,P=0.005).Conclusion HP infection is correlated to CAS and may improve the occurrence of cardiovascular diseases.

关 键 词：颈动脉粥样硬化 幽门螺杆菌感染 

分 类 号：R543[医药卫生—心血管疾病]