冠心病患者幽门螺杆菌感染与斑块特征、脂代谢、炎症反应的相关性

Relationship between Helicobacter pylori infection and plaque characteristics, lipid metabolism, inflammatory response in patients with coronary heart disease

目的探讨冠心病患者幽门螺杆菌(Hp)感染与斑块特征、脂代谢、炎症反应的相关性。方法选取2017年8月至2019年3月本院首诊的冠心病患者178例作为研究对象,根据Hp感染检测结果进一步分为Hp阳性组65例、Hp阴性组113例。对比2组冠心病患者冠状动脉造影结果、颈动脉超声斑块特征,以及外周血脂代谢指标、血清炎症介质水平的差异。结果冠状动脉造影结果显示,2组冠心病患者的冠状动脉病变支数、斑块性质差异有统计学意义(P<0.05)。Hp阳性组Gensini积分大于Hp阴性组(P<0.01)。Hp阳性组的颈动脉超声斑块面积、内膜中膜厚度大于Hp阴性组(P<0.01);2组斑块性质差异有统计学意义(P<0.05)。Hp阳性组血总胆固醇、低密度脂蛋白胆固醇水平高于Hp阴性组,高密度脂蛋白胆固醇水平低于Hp阴性组(P<0.01)。Hp阳性组血清白细胞介素6、白细胞介素18、肿瘤坏死因子α、高敏C反应蛋白水平高于Hp阴性组(P<0.05)。结论合并Hp感染可能是导致冠心病患者斑块稳定性下降、脂质代谢紊乱加剧、炎症反应加重的重要因素之一。

Aim To investigate the relationship between Helicobacter pylori (Hp) infection and plaque characteristics, lipid metabolism and inflammatory response in patients with coronary heart disease. Methods 178 patients with coronary heart disease who were first diagnosed in our hospital from August 2017 to March 2019 were selected as the subjects of study. According to the results of detection of Hp infection, the patients were further divided into 65 cases of Hp positive group and 113 cases of Hp negative group. The differences of coronary angiographic results, carotid ultrasound plaque characteristics, peripheral blood lipid metabolism and serum inflammatory mediators levels were compared between the two groups. Results The results of coronary angiography showed that there were significant differences in the number of coronary artery lesions and the nature of coronary plaque between the two groups (P<0.05). Gensini score of Hp positive group was higher than that of Hp negative group (P<0.01). Plaque area of carotid ultrasound, intima-media thickness in Hp positive group were larger than those in Hp negative group (P<0.01);There was significant difference in plaque nature between the two groups (P<0.05). The levels of serum total cholesterol and low density lipoprotein cholesterol in Hp positive group were higher than those in Hp negative group, and the level of high density lipoprotein cholesterol was lower than that in Hp negative group (P<0.01). The serum levels of interleukin-6, interleukin-18, tumor necrosis factor α and high-sensitivity C-reactive protein in Hp positive group were higher than those in Hp negative group (P<0.05). Conclusion The combination of Hp infection may be one of the important factors leading to the decrease of plaque stability, the increase of lipid metabolism disorder and the aggravation of inflammatory reaction in patients with coronary heart disease.