幽门螺杆菌现症及既往感染与心脑血管疾病的关系

Relation between current and past infection Of Helicobacter pylori and cardiovascular and cerebrovascular diseases

目的观察体检人群幽门螺杆菌（Hp）感染情况，探讨Hp感染与心脑血管疾病的关系。方法采用13C尿素呼气检测方法检测首都医科大学附属北京安贞医院体检中心2025例体检者Hp的感染状况，按Hp感染情况分为Hp现症感染组（754例）、既往Hp感染组（555例）和未感染组（716例），比较3组间生理、生化指标及心脑血管疾病患病率的差异。结果Hp现症感染组的年龄、冠心病史患者比例、脑卒中病史患者比例、向细胞计数、空腹胰岛素水平、胰岛素抵抗指数、高密度脂蛋白胆固醇（HDL-c）及c反应蛋白（CRP）与未感染组比较，差异均有统计学意义[（61±14）岁比（56±12）岁、12．1％（91／754）比7．8％（56／716）、9．8％（74／754）比5．3％（29／716）、（12．5±2．5）×10^9／L比（7．6±1．8）×10^9／L、（10．6±2．0）μU／L比（6．8±1．2）μU／L、（2．9±0．6）比（1．5±0．3）、（1．2±0．4）mmol／L比（1．5±0．3）mmol／L、（8．2±1．8）mg／L比（3．4±0．8）mg／L]（P〈0．05或P〈0．01）。既往Hp感染组的冠心病史及脑卒中病史患者比例高于未感染组[10．5％（58／555）、8．5％（47／555）]（P〈0．05）。Hp感染与心脑血管疾病的患病相关（Hp现正感染组：比值比（OR）=2．85，95％CI：2．13—3．36，P〈0．05；既往Hp感染组：OR=1．89，95％CI：1．34～2．41，P〈0．05）。高血压病史及空腹血糖、HDL—C、CRP水平与Hp现症感染和既往Hp感染均有明显相关洼，HOMA—IR和低密度脂蛋白胆固醇水平与Hp现症感染相关（P〈0．05）。结论Hp现症感染和既往Hp感染均与心脑血管疾病的患病卡相关，预防、治疗Hp感染对心脑血管疾病的预防和控制有重要的意义。

Objective To observe the helicobacter pylori （Hp） infection rate among health examination population and to study the relation between Hp infection and cardiovascular and cerebrovascular diseases. Methods Totally 2 025 persons from health examination were separated into three groups：current Hp infection group（754 cases）, past Hp infection group（555 cases） and non Hp infection group（716 cases）. Difference of physiological and biochemical indexes morbidity of cardiac-cerebral vascular disease were compared. Results There were significant differences of age, number of coronary heart disease （CHD） and cerebral apo- plexy patients, white blood cell count, fasting insulin level, homeostasis model assessment of insulin resistance （HOMA-IR）, high density lipoprotein cholesterol （HDL-C） and C react protein （CRP） between the 2 groups [（61±14）yearsvs （56 ±12）years, 12. 1% （91/754） vs 7. 8% （56/716）, 9.8%（74/754）vs 5.3% （29/ 716）, （12.5 ±2.5）×109/Lvs （7.6±1.8） ×109/L,（10.6±2.0）μU/Lvs （6.8±1.2）μU/L, （2.9 ±0.6） vs （1.5 ±0.3） , （1.2 ±0.4）mmol/L vs （1.5 ±0.3）mmo]/L, （8.2 ± 1.8）mg/L vs （3.4 ±0.8）mg/L] （P〈 0.05 ）. Proportion of CHD and cerebral apoplexy patients of past Hp infection group were higher than that of non Hp infection group[ 10.5% （ 58/555 ）, 8.5% （ 47/555 ） ] （ P 〈 0.05 ）. Hp infection was associated with cardiovas- cular and cerebrovascular disease odds ratio[ current Hp infection, （OR） = 2.85, 95% confidence interval（CI） ： 2.13-3.36,P 〈 0.05 ] ; past Hp infection, OR = 1.89, 95 % CI： 1.34-2. 41 ,P 〈 0.05 ）. CHD, fasting blood-glu- cose, HDL-C and CRP were associated with current and past Hp infection; HOMA-IR and LDL-C were associated with current Hp infection. Conclusions Current and past Hp infection are associated with cardiovascular and ce- rebrovascular diseases. Prevention and treatment of Hp infection are very important for prevention and controlling of cardiovascular and cerebrovaseular disease.