摘要
目的探讨幽门螺杆菌（Hp）感染对冠心病患者氧化低密度脂蛋白（oxLDL）及颈动脉硬化的影响及其可能的发病机制。方法选择2006年12月至2007年12月冠心病住院患者159例，其中男115例，女44例，年龄30～88岁，平均（63±10）岁，近期无感染性疾病及慢性炎症性疾病，有典型的心绞痛病史及心电图的改变，冠状动脉造影均显示至少1支冠状动脉管腔内径狭窄≥50％。采用呼气试验来检测患者是否感染Hp，并根据结果将冠心病患者分为3组：阴性感染组，轻度感染组和重度感染组，使用彩色超声检测患者颈动脉内膜中层厚度（IMT）及颈动脉斑块，同时测定血浆高敏C反应蛋白（hsCRP）、尿酸、纤维蛋白原、oxLDI，和血脂水平。结果3组间胆固醇、低密度脂蛋白胆同醇（LDL—C）、hsCRP及oxLDL水平比较，差异均有统计学意义（均为P〈0．05），且在重度感染组水平最高；阴性感染组、轻度感染组和重度感染组IMT分别为（0．91±0．21）mm、（1．03±0．40）mm和（1．214±0．51）mm，3组间比较，差异有统计学意义（P〈0．05）。结论Hp感染能增加冠心病患者颈动脉粥样硬化的风险，并且重度感染可能会伴随更高的风险，Hp感染可能通过影响脂质代谢、加速LDL氧化和激活炎症反应来促进颈动脉粥样硬化发展。
Objective To investigate the effect of Helicobacter pylori （Hp） infeetion on oxidized low density protein （oxLDL） and carotid arterial atherosclerosis in patients with coronary heart disease. Methods A total of 159 coronary heart disease patients were recruited to this study. Cases with ≥50% stenosis in at least one of the three coronary vessels were defined as having coronary heart disease by angiography. And serum fibrinogen, lipid, urine acid, oxLDL, high sensitive C-reactive protein（hsCRP） and intlma-media thickness （IMT） and plaque of carotid artery were examined in all subjects. Current Hp infection was determined in all study participants by means of a modified [ ^13C] urea breath test. All subjects were divided into 3 groups, including negative infection group, slight infection group and serious infection group. Results There were significant differences in the levels of serum total cholesterol, low density fipoprotein, hsCRP and oxLDL among 3 groups （P 〈 0. 05）. The levels of these parameters metioned above were highest in CHD patients with Hp serious infection. The IMT in negative infection group, slight infection group and serious infection group were （0. 91 ± 0. 21 ）, （ 1.03 ±0. 40） and （ 1.21 ±0. 51 ） mm respectively. There were significant differences in IMT among three groups （ P = 0. 003）. Conclusions Hp infection may increase the risk of carotid atherosclerosis in CHD patients. Hp infection might be involved in coronary atherosclerosis by modifying serum lipids, enhancing LDL oxidation and activating the inflammatory responses.
出处
《中国心血管杂志》
2010年第3期190-192,共3页
Chinese Journal of Cardiovascular Medicine
基金
广东省番禺区科技局攻关项目(2007-Z-79-1)
关键词
螺杆菌
幽门
心脏病
C反应蛋白质
脂蛋白类
Helicobacter pylori
Heart diseases
C-reactive protein
Lipoproteins
作者简介
通讯作者：林桂雄，电子信箱：hbs8311@163．com
