艾普拉唑肠溶片联合铋剂四联疗法对幽门螺杆菌感染患者糖脂代谢的影响

Effects of ilaprazole enteric-coated tablets combined with the bismuth quadruple therapy on the glucose and lipid metabolism in patients with Helicobacter pylori infection

目的观察艾普拉唑肠溶片联合铋剂四联疗法对幽门螺杆菌(H.pylori)阳性患者疗效、糖脂代谢指标的影响。方法纳入2019年1月至2020年6月消化科门诊收治的H.pylori阳性患者106例,按随机数字表法将其分为对照组54例,研究组52例。研究组患者采用含艾普拉唑肠溶片的四联疗法治疗14 d,药物治疗前及治疗完成8周后采集患者空腹血样,全自动生化分析仪检测患者空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C),酶联免疫吸附法(ELISA)检测患者肌联素(Myonectin)、空腹胰岛素水平(FIns),计算稳态模型胰岛素抵抗指数(HOMA-IR),对Myonectin水平与糖脂代谢指标的进行Person相关性及多元线性回归分析。结果治疗后按ITT分析,研究组患者Hp根除率为90.38%。按PP分析,研究组患者Hp根除率为94.23%;治疗后研究组患者FPG、Fins、HOMA-IR、Myonectin水平低于对照组患者,差异有统计学意义(均P<0.05),研究组患者TC、TG、LDL-C水平均低于对照组(均P<0.05),Person相关分析显示Myonectin变化水平与FPG、FIns、HOMA-IR、TC、TG、LDL-C变化水平呈正相关(P<0.05),进一步多元线性回归分析显示Myonectin变化水平FIns、HOMA-IR、TC、变化水平呈正相关(P<0.05)。结论含艾普拉唑肠溶片的铋剂四联疗法对Hp感染具有较高的根除率,对Hp感染患者糖脂代谢水平具有明显的改善作用,其机制可能与Myonectin相关。

Objective To investigate the effects of ilaprazole enteric-coated tablets combined with the bismuth quadruple therapy on the glucose and lipid metabolism in patients with Helicobacter pylori(H.pylori)infection.Methods A total of 106 patients with positive H.pylori who were treated in our hospital from January 2019 to June 2020 were enrolled in the study,who were randomly divided into control group(n=54)and research group(n=52).The patients in research group were treated by bismuth quadruple therapy combined with ilaprazole enteric-coated tablets for 14 days.The fasting blood specimens were respectively collected before treatment and at 8 weeks after treatment.The levels of fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were measured by using an automatic biochemical analyzer.And the levels of myonectin and fasting insulin(FIns)were detected by enzyme-linked immunosorbent assay(ELISA),and the index of homeostasis model assessment for insulin resistance(HOMA-IR)was calculated,and Pearson correlation analysis and multiple linear regression analysis were performed to analyze the myonectin level and the glucose and lipid metabolism indexes.Resutls After treatment,according to ITT analysis,the eradication rate of H.pylori in research group was 90.38%,and according to PP analysis,the eradication rate of H.pylori was 94.23%.After treatment,the levels of FPG,FIns,HOMA-IR and myonectin in research group were significantly lower than those in control group(P<0.05),and the levels of TC,TG,and LDL-C in research group were significantly lower than those in control group(P<0.05).Person correlation analysis showed that the changes of the myonectin levels were positively correlated with those of FPG,FIns,HOMA-IR,TC,TG,and LDL-C,so were with those of FIns,HOMA-IR and TC(P<0.05).Conlusion The bismuth quadruple therapy combined with ilaprazole enteric-coated tablets has higher eradication rate for H.pylori infection,which can improve the levels of glucose and lipid metabolism in patients with H.pylori infection,and its action mechanism may be related to myonectin.