幽门螺杆菌感染与血清同型半胱氨酸水平及颈动脉粥样硬化的关系

The relationship between Helicobacter pylori infection and serum homocysteine level and carotid atherosclerosis

目的探讨颈动脉粥样硬化患者幽门螺杆菌(Hp)感染与颈动脉内膜中层厚度、动脉粥样硬化斑块稳定性及血清同型半胱氨酸(Hcy)水平的关系。方法选取颈动脉粥样硬化患者206例,根据14 C尿素呼气试验分为Hp感染组和非Hp感染组。同时根据颈动脉粥样硬化程度将Hp感染组又分为颈动脉内膜中层增厚组、稳定性斑块组和不稳定性斑块组。采用循环酶法测定血清Hcy水平,分析Hp感染和血清Hcy水平的相关性以及与颈动脉内膜中层厚度、颈动脉斑块稳定性的关系。结果 Hp感染组血清Hcy水平和颈动脉内膜中层厚度与非Hp感染组比较差异均有统计学意义(P<0.01)。Hp感染组和非Hp感染组颈动脉粥样硬化类型的构成比差异有统计学意义(χ2=15.939,P=0.000 3)。在Hp感染组中,不稳定性斑块组、稳定性斑块组、颈动脉内膜中层增厚组血清Hcy水平比较差异均有统计学意义(P<0.01)。直线相关分析显示,Hp感染组血清Hcy水平与颈动脉内膜中层厚度呈正相关(r=0.731,P<0.01)。结论 Hp感染可能通过影响血液Hcy水平使颈动脉内膜中层增厚,并导致颈动脉粥样硬化斑块的不稳定性增加,从而促进颈动脉粥样硬化的发生和发展。

Objective To explore the relationship between Helicobacter pylori（Hp） infection and serum homocysteine（Hcy） level ,carotid intima-media thickness and plaque stability in carotid atherosclerosis cases .Methods 206 carotid atherosclerosis pa-tients were collected between March 2012 and January 2013 in our hospital .According to the results of 14C urea breath test ,all the subjects were divided into Hp infection group and non-Hp infection group .And according to the degree of carotid artery atheroscle-rosis ,patients with Hp infection were divided into carotid intima-media thickness thickening group ,stable plaque group and unstable plaque group .The serum Hcy level was detected by enzymatic cycling method ,and the relationship between Hp infection and serum Hcy level ,carotid intima-media thickness and plaque stability in carotid atherosclerosis cases were analyzed .Results Serum Hcy level and carotid carotid intima-media thickness of patients with carotid atherosclerosis in Hp infection group were higher than those in non-Hp infection group（P〈0 .01） .The differences in constitution ratio of patients with different types of carotid atherosclerosis in Hp infection group and non-Hp infection group was statistically significant（χ2 =15 .939 ,P=0 .000 3） .In Hp infection group , there were statistically of serum Hcy levels among carotid intima-media thickness thickening group ,stable plaque group and unsta-ble plaque group（P〈0 .01） .Linear correlation analysis showed that the serum Hcy level and carotid intima-media thickness were positively correlated in Hp infection group（r=0 .731 ,P〈0 .01） .Conclusion Hp infection is likely to promote the development and progression of atherosclerosis through influencing Hcy metabolism and increasing carotid intima-media thickness and instability of carotid atherosclerotic plaque .