幽门螺旋杆菌感染与血糖的相关性分析

Study on relationship between Helicobacter pylori infection and blood glucose

目的探讨血糖与幽门螺旋杆菌(H.pylori)感染的相关性及对根除疗效、复发的影响。方法选取兰州大学第一医院体检中心2010年3月至2019年12月体检的1584例2型糖尿病患者,年龄44~91(66.6±7.6)岁,其中男性1063例(67.1%),女性521例(32.9%)。采用Logistic回归分析方法对纳入患者的年龄、性别、空腹血糖、H.pylori感染情况进行横断面研究。采用含铋剂四联疗法对血糖控制达标组(糖化血红蛋白<7%)263例和不达标组(糖化血红蛋白≥7%)271例老年2型糖尿病患者及对照组(269例)进行H.pylori根除治疗,并比较根除疗效、不良反应及1年后复发情况。结果2型糖尿病患者H.pylori感染率为48.2%(763例),血糖控制不佳增加H.pylori感染风险(OR=1.611,95%CI:1.269~2.045,P<0.01)。803例完成H.pylori根除治疗,总体根除率为90.9%(730例),不同血糖组、对照组间比较根除率差异无统计学意义(均P>0.05)。1年后总体复发率为3.8%(27/730),血糖控制不达标组复发率高于对照组和达标组(P<0.05)。便秘是根除治疗最主要的不良反应,且糖尿病组25.1%(134/253)和对照组16.4%(44/269)患者比较差异有统计学意义(P<0.01)。结论2型糖尿病患者血糖控制不佳增加H.pylori感染和复发风险。

Objective To examine the relationship between fasting blood glucose(FBG)levels and H.pylori infection,as well as their impact on eradication and recurrence rates.MethodsA total of 1584 patients with type 2 diabetes,ranging in age from 44 to 91 years old(mean age of 66.6±7.6 years),were included in this study conducted at the Physical Examination Center of the First Hospital of Lanzhou University between March 2010 and December 2019.Of the total participants,1063(67.1%)were male and 521(32.9%)were female.Logistic regression analysis was performed to investigate the impact of age,gender,fasting blood glucose,and H.pylori infection on the patients.In the study,263 patients in the euglycemic control group(HbA1c<7%),271 patients in the poor glycemic control group(HbA1c≥7%),and 269 patients in the control group underwent H.pylori eradication using bismuth-containing quadruple therapy,and the eradication efficacy,adverse reactions,and recurrence rates were compared after 1 year.ResultsIn patients with type 2 diabetes,the infection rate of H.pylori was found to be 48.2%.Further regression analysis revealed that poor glycemic control increased the risk of H.pylori infection(OR=1.611,95%CI:1.269~2.045,P<0.01).However,the constituent ratio and infection rate of different hypoglycemic drug groups did not show any significant statistical difference.The eradication rate of H.pylori was 90.9%,and there was no significant difference in the eradication rate among different blood glucose groups and control groups.However,after 1 year,the recurrence rate was 3.8%,with a higher rate observed in the poor glycemic control group compared to the euglycemic control group and the control group(P<0.05).There was a statistically significant difference in constipation as the main side effect of eradication therapy between the diabetic group and the control group[25.1%(134/253)vs.16.4%(44/269),P<0.01].ConclusionsDiabetic patients with fasting hyperglycemia or poor glycemic control are at an increased risk of H.pylori infection.Additionally,these patients have a higher risk of recurrence after eradication.Therefore,it is important for clinicians to closely monitor and manage glycemic control in diabetic patients to reduce the risk of H.pylori infection and improve treatment outcomes.