颈动脉斑块与幽门螺杆菌感染的相关性研究

The association between carotid artery plaque and Helicobacter pylori infection

目的:探讨体检人群颈动脉斑块与幽门螺杆菌感染之间的关系。方法:选取2019年1至12月在中日友好医院体检中心接受颈动脉超声和13C呼气试验检查的体检人员共3066例,分为颈动脉斑块组和无斑块组,使用独立样本t检验、Mann-Whitney U检验、χ^(2)检验分析两组间理化检查指标和幽门螺杆菌感染阳性率的差异;使用Logistic回归分析颈动脉斑块与幽门螺杆菌阳性的相关性。结果:颈动脉斑块检出率男性多于女性(33.4%比19.5%),幽门螺杆菌阳性率不同性别之间差异没有统计学意义(29.1%比30.9%)。颈动脉斑块组年龄[(59.39±10.24)比(46.44±9.88)岁]、体质指数[(25.44±3.23)比(24.21±3.54)kg/m^( 2)]、收缩压[(135.91±19.07)比(123.03±16.66)mmHg(1 mmHg=0.133 kPa)]、舒张压[(79.64±11.47)比(75.10±11.55)mmHg]、总胆固醇[(4.96±0.98)比(4.86±0.98)mmol/L]、三酰甘油[1.43(1.03,2.06)比1.20(0.82,1.88)mmol/L]、低密度脂蛋白胆固醇[(3.21±0.93)比(3.04±0.83)mmol/L]、空腹血糖[5.55(5.11,6.47)比5.16(4.83,5.56)mmol/L]、尿酸[(339.13±79.92)比(319.85±87.62)mmol/L]、同型半胱氨酸[13.10(11.30,15.60)比11.7(10.00,13.90)mmol/L]均高于无斑块组,高密度脂蛋白胆固醇低于无斑块组[1.12(0.95,1.32)比1.20(1.00,1.43)mmol/L],差异均有统计学意义;颈动脉斑块组男性(62.4%比44.6%)、吸烟(31.9%比19.6%)、有高血压病史(33.8%比12.5%)、糖尿病病史(13.5%比3.5%)的研究对象占比高于无斑块组,颈动脉斑块组幽门螺杆菌阳性率高于无斑块组(34.5%比28.4%),差异均有统计学意义。Logistic回归分析显示调整混杂因素后颈动脉斑块与幽门螺杆菌阳性呈显著正相关(OR=1.270,P=0.028)。结论:颈动脉斑块的形成与多种因素相关,而幽门螺杆菌感染也是颈动脉斑块形成一个重要的危险因素,治疗幽门螺杆菌感染可能是防控颈动脉斑块形成的有效措施。

Objective To investigate the prevalence of carotid artery plaque(CP)in the population undergoing health examinations and to assess the association between CP and Helicobacter pylori(Hp)infection.Methods The subjects were 3066 patients who underwent carotid ultrasonography examination and 13C urea breath test(UBT)at the health examination center of China-Japan friendship hospital from January 2019 to December 2019.The subjects were divided into CP and non-CP groups;the differences of physicochemical parameters and UBT positive rate between the two groups were analyzed by independent sample t test,Mann-Whitney U test,and Chi-squared test.The association between UBT positive and CP was analyzed by logistic regression.Results The proportion of CP positive subjects was significantly higher in males than in females(33.4%vs 19.5%,P<0.001);the proportion of Hp positive subjects was not significant in sex composition(29.1%vs 30.9%,P=0.245);the age[(59.39±10.24)vs(46.44±9.88)years],(P<0.01),BMI[(25.44±3.23)vs(24.21±3.54)kg/m^( 2),P<0.01],SBP[(135.91±19.07)vs(123.03±16.66)mmHg,P<0.01],DBP[(79.64±11.47)vs(75.10±11.55)mmHg,P<0.01],TC[(4.96±0.98)vs(4.86±0.98)mmol/L,P=0.004],TG[1.43(1.03,2.06)vs 1.20(0.82,1.88)mmol/L,P<0.001],LDL-c[(3.21±0.93)vs(3.04±0.83)mmol/L,(P<0.01)],FBG[5.55(5.11,6.47)vs 5.16(4.83,5.56)mmol/L,P<0.001],UA[(339.13±79.92)vs(319.85±87.62)mmol/L,P<0.01]and Hcy[13.10(11.30,15.60)vs 11.7(10.00,13.90)mmol/L,P<0.001]were significantly higher in the CP group than that in the non-CP group;HDL-c was significantly lower in the CP group than in the non-CP group[1.12(0.95,1.32)vs 1.20(1.00,1.43)mmol/L,P<0.001].The proportion of male(62.4%vs 44.6%,P<0.01),prevalence of tobacco smoking(31.9%vs 19.6%,P<0.01),hypertension(33.8%vs 12.5%,P<0.01),and diabetes(13.45%vs 3.5%,P<0.01)were significantly higher in the CP group than that in the non-CP group.The proportion of UBT positive subjects was significantly higher in the CP group than in the non-CP group(34.5%vs 28.4%,P=0.001).Logistic regression analysis showed a significantly positive association between CP and UBT positive after adjusted confounding factors(OR=1.270,P=0.028).Conclusions The formation of CP is related to many risk factors;Hp infection is also an important risk factor.Controlling Hp infections might be one of the effective methods for the prevention and control of carotid plaque formation.