幽门螺杆菌根除前后对CagA^+冠心病患者血管内皮功能的影响

Effect of Helicobacter pylori^+ CagA^+ eradication on vascular endothelial function in patients with coronary heart disease

目的:探讨幽门螺杆菌(Hp)根除前后细胞毒素相关基因A阳性(CagA+)对冠状动脉粥样硬化性心脏病(冠心病)患者血管内皮功能的影响。方法:选择Hp+CagA+冠心病患者57例为根除治疗组,同期住院的57例Hp-CagA-冠心病患者为对照组。在常规治疗的基础上,根除治疗组接受根除Hp治疗,对照组接受安慰剂治疗,研究期为6个月。两组研究对象在实验前后接受血脂、外周血循环内皮微颗粒(cEMP)水平及肱动脉对反应性充血的内皮依赖血管扩张反应(FMD)检测。结果:治疗后根除治疗组患者的血浆总胆固醇、cEMP水平比治疗前明显降低,FMD明显升高(P均<0.05)。治疗前根除治疗组总胆固醇高于对照组(P<0.01),治疗后两组总胆固醇比较差异无统计学意义(P>0.05)。结论:根除Hp+CagA+,可改善合并Hp+CagA+感染冠心病患者的血管内皮功能。

Objective：To investigate the effect of Helicobacter pylori＋CagA＋（Hp＋CagA＋） eradication on vascular endothelial function in patients with coronary heart disease（CHD）.Methods：Fifty-seven CHD patients infected with Hp＋CagA＋（eradication therapy group）and fifty-seven CHD patients with Hp-CagA-（control group） were recruited in the study.Patients in the eradication therapy group were treated with eradication therapy for Hp.While the latter group were treated with placebo besides general treatment.The follow-up period was 6 months.The levels of plasma lipids,circulating endothelial-derived microparticle（cEMP） and flow-mediated dilation（FMD） were performed at the beginning and the end of study in all subjects.Results：In comparison with the levels at the beginning,the levels of plasma total cholesterol and cEMP were significantly decreased and FMD significantly increased in eradication therapy group at the end of study,P〈0.05.At the end of study,no significance was found in the levels of plasma total cholesterol between two groups（P〉0.05） despite of a significantly increased plasma total cholesterol level in eradication therapy group in comparison with control group at enrollment（P〈0.01）.Conclusion： Hp＋CagA＋ eradication might improve the vascular endothelial function in CHD patients infected with Hp＋CagA＋.