幽门螺杆菌感染对冠心病患者血清MMP-2和MMP-9的影响

Influence of helicobacter pylori infection on serum MMP-2 and MMP-9 in patients with Coronary heart disease

目的：探讨幽门螺杆菌（HP）感染对冠心病（CHD）患者血清MMP-2和MMP-9的浓度的影响。从而探讨CHD与HP感染的关系及其可能的发病机制，为CHD的早期防治探讨-种新的手段和依据。方法：选取2011年3月至2013年1月菏泽市立医院心内科住院，回顾性分析行心电图、冠状动脉造影检查并结合病史诊断为急性冠状动脉综合征（ACS）患者97例、急性心肌梗死（AMI）患者74例共171例患者为CHD组，并同时选取无CHD体征的健康体检者146例为对照组，对各组进行尿素[Cl4]呼气实验及ELLSA法测HP细胞毒素相关基因蛋白（HP—CagA-IgG）试验，比较各组HP感染阳性率。再把上述二试验均HP阳性的CHD患者分为HP重度感染组、HP轻度感染组，把HP阴性的无CHD体征的健康体检组为HP感染阴性组。对2L．F-组分别用ELLSA法罗氏全自动酶标仪进行MMP-2和MMP-9检测，对各组检测结果进行统计学分析，比较各组与对照组间的差异及HP轻度感染组与HP重度感染组间的差异。结果：①CHD组尿素fCl41呼气试验阳性率（76．7％）、HP—CagA—IgG试验阳性率（71．9％）明显高于无CHD体征的健康体检组尿素[C14]呼气试验阳性率（51．4％）、HP—CagA-IgG试验阳性率（43．4％）（P〈0．01）。②HP重度感染组MMP-2（337±131）ug／L、MMP-9（375±143）ug／L明显高于HP感染阴性组MMP-2（136±69）ug／L、MMP-9（145±91）ug／L（P〈0．001）；HP轻度感染组MMP-2（235±129）ug／L、MMP-9（286±137）ug／L亦明显高于Hp感染阴性组（P〈0．001）；HP重度感染组与HP轻度感组之间亦有显著性差异（P〈0．01）。结论：HP感染可能通过炎性细胞的浸润分泌多种炎性因子和脂质过氧化物。诱导内皮细胞大量分泌MMP-2和MMP-9，从而加速动脉粥样硬化斑块的形成和发展；HP感染阳性患者发生CHD的几率可能增高。

Objective ： Investigate influence of Helicobacter pylori infection on MMP-2 and MMP-9 in serum in patients with Coronary heart disease and, study relationship of Coronary heart disease and helicobacter pylori infection and, to explore a new good method for treating and guarding against coronary heart disease more early. Methods ： Fifty-seven case of patients diagnosed as ACS and forty-four case of patients diagnosed as AMI according to x-ray of the coronary arteries and electrocardiogram altogether one hundred-one case of coronary heart disease from March 2011 to January 2013 hospitalized in municipal hospital of ShanDong heze.Results ： First, the positive rate（76.7%） with 14C urea breath test and the positive rate （71.9%） with HP-CagA- IgGtest of HP infection in CHD group（101case） were all significantly higher than the positive rate（51.4%） with 14C urea breath test and the positive rate（43.4%） with HP-CagA-IgG test in control group（100 case） without coronary heart disease（P〈0.01）. Second, MMP-2 （ 337 ± 131 ） ug/Land MMP-9 （ 375± 143 ） ug/Lin serum in serious infection of liP positive CHD group was significantly higher than MMP-2（136 ±69）ug/L and MMP-9 （ 145 ± 91）ug/L in serum in the negative HP infections（P〈0.001） ; MMP-2 （ 235± 129 ） ug/Land MMP-9（286 ±137）ug/L in serum in mild infection of HP positive CHD group was also significantly higher than the negative HP infections（P〈0.001）, and the difference was more notable between serious infection of HP positive CHD group and mild infection of HP positive CHD group（P〈0.01）. Gonclusiofls ： HP infection may be through the infiltration of inflammatory cells secrete a variety of inflammatory factors and lipid peroxide, induced endothelial cells secrete a large number of MMP-2 and MMP-9, so as to accelerate the formation and develoment of atherosclerotic plaque; HP infection incidence of CHD positive patients may be increased.