幽门螺杆菌感染对冠心病患者内皮功能及血清同型半胱氨酸的影响

Effects of Helicobacter Pylori Infection on Endothelial Function and Homocysteine in Coronary Heart Disease Patients

目的观察感染幽门螺杆菌和未感染幽门螺杆菌的冠心病患者内皮功能及血清同型半胱氨酸(Hcy)水平的变化,探讨幽门螺杆菌感染和冠心病发病的关系。方法应用ELISA法检测冠心病组患者(242例)和非冠心病组患者(88例)血清Hp抗体(HpIgG),比较两组HpIgG阳性率。应用放射免疫法检测冠心病组中HpIgG阳性和HpIgG阴性患者的前列环素I2(PGI2)、血栓素B2(TXB2)、内皮舒张因子一氧化氮(NO)、白介素-1β(IL-1β)、Hcy、叶酸、维生素B12(VitB12)水平。结果冠心病组血清HpIgG阳性率明显高于非冠心病组HpIgG阳性率(53.3%和38.6%,χ2=5.556,P<0.05)。冠心病组HpIgG阳性者TXB2、6-K-PGF1α、Hcy水平分别为(262±86)pg/ml、(276±75)pg/ml、(18±6)μmol/L,HpIgG阴性者TXB2、6-K-PGF1α、Hcy水平分别为(216±65)pg/ml、(299±70)pg/ml、(16±5)μmol/L,两组上述指标水平间差别均有统计学意义(P<0.05);冠心病组HpIgG阳性者和HpIgG阴性者NO、IL-1β、叶酸和VitB12水平间差别无统计学意义(P>0.05)。结论幽门螺杆菌感染与冠心病发病有关,幽门螺杆菌可能导致内皮功能障碍及升高Hcy水平来促进冠心病的发生和发展。

Objective To investigate the effects of Helicobacter pylori infection on endothelial function and Homocysteine in coronary heart disease(CHD)patients.Methods Serum HpIgG was measured in 242 CHD patients and 88 subjects without CHD,and the positive rates of both groups were compared.The levels of prostaglandin I2(PGI2),thromboxane B2(TXB2),nitric oxide(NO),interleukin-1β(IL-1β),Hcy,folate (fol),vitamin B12(VitB12) were determined by radioimmunoassay in HpIgG positive and negative patients of CHD group.Results The HpIgG seropositivity rate was significantly higher in CHD group than in control(53.3% vs 38.6%,χ2=5.556,P<0.05).The levels of plasma TXB2 ,6-K-PGF1αand Hcy were (262±86)pg/ml,(276±75)pg/ml,(18±6)μmol/L,respectively,in HpIgG positive patients of CHD group,and (216±65)pg/ml,(299±70)pg/ml,(16±5)μmol/L,respectively,in negative patients,the differences were significant (P<0.05),and no significant difference was noted in the levels of NO,IL-1β,Fol and VitB12 between two group(P>0.05).Conclusion Hp infection,associated with CHD,may increase serum Hcy and change endothelial function to promote the genesis and development of CHD.