慢性阻塞性肺病幽门螺杆菌感染状况及其致病危险性分析

Analysis of infection status of Helicobacter pylori and risk with COPD

目的:分析慢性阻塞性肺病(COPD)患者幽门螺杆菌(Hp)的感染情况及其致病危险性。方法:选取我院确诊的116例COPD患者(病例组)和同时期体检中心相匹配的健康志愿者116例(对照组),采用ELISA方法检测样本血清Anti-Hp-IgG和白介素-6、17(IL-6、IL-17)的水平。分析两组Hp感染情况,Hp感染与IL-6、IL-17、肺功能的相关性及与COPD患病的危险性(OR值)。结果:COPD组血清抗Hp阳性率达到71.55%,明显高于对照组(43.97%,P<0.05);Hp感染株型为I型Hp菌株和Ⅱ型Hp菌株,感染率分别为38.80%和32.75%,病例组I型Hp菌株感染率明显高于对照组(P<0.05);Hp感染阳性率与COPD患病危险性关联系数达到3.35,两者具有相关性(P<0.05);Hp感染阳性组IL-6、IL-17水平分别为(13.04±5.67)、(7.15±2.26)pg/mL,明显高于对照组(P<0.05);而肺功能指标1s用力呼气容积占预计值的百分率(FEV1%)仅为(42.25±11.83),低于对照组(P<0.05);Hp感染阳性率与FEV1%和IL-17相关系数达到-0.672和0.683,两者间存在显著相关(P<0.05);FEV1%与IL-17相关系数达到-0.620,两者呈负相关(P<0.05)。结论:Hp感染是导致COPD独立危险因素之一,其可启动体内炎症反应,促进COPD进展,导致患者肺功能下降,其机制可能与激活炎症因子IL-17有关。

Objective： To analyze the infection of Helicobacter pylori （Hp） and risk in the chronic obstructive pulmonary disease （COPD） patients. Methods. A total of 116 cases of COPD in our hospital （the case groups） and 116 cases of healthy volunteers （the control groups） at the same period were selected. The ELISA was used to detect the level of anti-Hp-IgG, IL-6 and IL-17 and the level of Hp infection and the relationship between infection and IL-6, IL-17 and pulmonary function and COPD risk （OR value） were analyzed. Results.. The serum anti Hp positive rate in the case groups was 71. 55%, significantly higher than the control groups 43.97% （P〈0.05） and the Ⅰ type and Ⅱ type infection rates were 38. 80% and 32.75 %. The infection rate of I type in the case groups were significantly higher than that of the control groups （P〈0.05）. The correlation coefficient between the Hp infection positive rate and prevalence risk of COPD reached 3.35 and had a significant correlation （P〈0.05）. The levels of IL-6, IL-17 in the Hp positive groups were [（13.04 ± 5.67） pg/mL] and [（7.15 ± 2.26） pg/mL], all significantly higher than that of the control groups （P〈0. 05） while the lung function index FEV1 % was （42.25 ± 11.83）, significant lower than that of the control groups （P〈0.05）. The coefficient between the positive rate of Hp infection and FEV1% and IL-17 were -0. 672 and 0. 683 （P〈0.05）. Conclusions. Hp infection is a independent risk factor leading to COPD and could start-up the inflammatory response, promote the progress of pulmonary function in patients with COPD and may be related to activation of inflammatory cytokine IL-17.