幽门螺杆菌感染与缺血性心脏病的关系探讨

Relation of Helicobacter pylori infection to ischemic heart disease.

目的 探讨幽门螺杆菌 (HP)感染与缺血性心脏病 (IHD)的关系以及可能的发病机理。方法 应用酶联免疫法测定 IHD组 (142例 )和对照组 (5 0例 )血清特异性 HP抗体 (HPIg G) ,用全自动生化仪测定血清 TC、TG、Apo A1 、Apo B、L p(a)、HDL - c、L DL - c含量 ;应用全自动凝血仪测定血中纤维蛋白原浓度 (Fbg) ,化学比色法测定血清中 NO和 NOS含量。结果 IHD组血清 HPIg G阳性率明显高于对照组 (6 5 .49% VS 2 8.0 0 % ,P<0 .0 0 0 1) ,经多元回归分析显示 HP感染与 IHD发病呈明显的正相关 (P=0 .0 0 0 4)。 HPIg G阳性者的 TG、Apo B、NO、NOS含量明显增高 (P<0 .0 5 ) ,TC、L p(a)、L DL- c、Fbg含量有增高趋势。结论 HP感染与 IHD的发生有明显的相关性 ,其可能的发病机理为 HP感染改变了脂质代谢和血管的内皮功能来增加发生 IHD的危险。

Objective To determine the relation ship of Helicobacter pylori(HP)infection with ischemic heart disease(IHD)and its possible mechanism.Methods Serum specific IgG antibodies to HP(HPIgG,ELISA)and serum levels of total cholesterol(TC),triglyceride(TG),apolipoprotein A 1(Apo A 1),apolipoprotein B(ApoB),apolipoprotein(a) ,high density apolipoprotein cholesterol(HDL c),low density apolipoprotein cholesterol(LDL c),fibrinogen(Fbg),nitric oxide(NO) and nitric oxide synthetase(NOS) were measured in 142 patients with CHD and 50 controls with other cardiovascular diseases.Results The rate of seropositive for HpIgG in IHD was significantly higher than that in controls(65.49% VS 28.00%, P <0.0001).Multiple analysis indicated that the HP infection was related positively to IHD( P =0.0004).The levels of serum TG,ApoB,NO,NOS in the cases of HP seropositivity were higher than those in the cases of HP seronegativity( P <0.05).The levels of TC,Lp(a),LDL c,Fbg tended to be higher in those who were HP positive than in those who were HP negative,but the trend was non significant.Conclusion HP infection might be associated with IHD;the possible mechanism is that HP infection might change the lipid metabolism and the vascular endothelial function in a way that could increase the risk of IHD.