冠心病发病与幽门螺杆菌感染相关性研究

Study on the correlation between the onset of coronary heart disease and Helicobacter pylori infection

目的 分析冠心病患者幽门螺杆菌(Helicobacter pylori,Hp)感染情况及患者血脂、炎性因子水平,探析冠心病发病与Hp感染的相关性。方法 选取108例冠心病患者及100例健康人群,检测Hp感染情况。对所有患者进行冠状动脉造影与颈动脉斑块检查,对比Hp阳性与Hp阴性患者冠状动脉造影结果与颈动脉斑块特征。采集患者静脉血,对比Hp阳性与Hp阴性患者血脂及炎症因子水平。将Hp阳性冠心病患者进行分组,对比联合治疗组与常规治疗组患者治疗前及治疗6个月后的血脂水平。结果 冠心病患者Hp阳性率为50.93%(55/108),对照组为34.00%(34/100),冠心病患者Hp阳性率高于对照组(P<0.05)。病例组Hp阳性患者中,45例为Ⅰ型感染,10例为Ⅱ型感染。对照组中,22例为Ⅰ型感染,12例为Ⅱ型感染,两组Ⅰ型Hp阳性率差异有统计学意义(P<0.05),Ⅱ型Hp阳性率差异无统计学意义(P>0.05)。Ⅰ型Hp感染与Ⅱ型Hp感染冠心病患者的单支、2支、3支冠状动脉病变比例差异无统计学意义(P>0.05)。Hp阳性患者与Hp阴性患者单支、3支冠状动脉病变构成比差异有统计学意义(P<0.05)。Hp阳性患者与Hp阴性患者稳定性斑块、不稳定的斑块及软斑构成比差异有统计学意义(P<0.05)。Hp阳性冠心病患者TC、TG、LDL-C、HDL-C水平分别为(5.07±0.64)mmol/L、(1.59±0.35)mmol/L、(3.34±0.56)mmol/L、(1.05±0.30)mmol/L,hs-CRP、TNF-α、IL-6水平分别为(12.19±0.84)mg/L、(57.85±4.04)ng/L、(40.17±3.60)ng/L。Hp阴性冠心病患者TC、TG、LDL-C、HDL-C水平分别为(4.24±0.52)mmol/L、(1.25±0.33)mmol/L、(2.98±0.38)mmol/L、(1.19±0.30)mmol/L,hs-CRP、TNF-α、IL-6水平分别为(9.07±0.81)mg/L、(40.14±4.18)ng/L、(31.66±4.55)ng/L,两组患者血脂水平及炎症因子水平差异有统计学意义(P<0.05)。经治疗前,联合治疗组与常规治疗组患者各血脂水平差异无统计学意义(P>0.05),治疗6个月后,联合治疗组TC、TG、LDL-C、HDL-C水平分别为(4.00±0.64)mmol/L、(1.28±0.38)mmol/L、(2.57±0.56)mmol/L、(1.40±0.31)mmol/L,常规治疗组分别为(4.62±0.54)mmol/L、(1.31±0.31)mmol/L、(3.12±0.60)mmol/L、(1.22±0.28)mmol/L,两组TC、LDL-C、HDL-C水平差异有统计学意义(P<0.05)。结论 冠心病患者Hp感染率高于健康人群,Hp阳性患者血脂、炎症因子水平高于Hp阴性患者,Hp感染可能影响人体脂质代谢功能而导致冠心病的发病。对Hp阳性冠心病患者进行抗幽门螺杆菌治疗,可有效提升治疗效率,改善患者血脂水平。

Objective Toanalyze the Helicobacter pylori(Hp)infection status,blood lipid and inflammatory factor levels of patients with coronary heart disease,and explore the correlation between the onset of coronary heart disease and Hp infection.Methods 108 patients with coronary heart disease and 1oo healthy people were selected for the detection of Hp infection.Coronary angiography and carotid plaque examination were performed on all patients,and the coronary angiography results and carotid plaque characteristics of Hp-positive and Hp-negative patients were compared.Venous blood of patients was collected to compare the levels of blood lipid and inflammatory factors between Hp-positive and Hp-negative patients.Hp-positive patients with coronary heart disease were grouped to compare the blood lipid levels of the combined treatment group and the conventional treatment group before treatment and 6 months after treatment.Results The positive rate of Hp in patients with coronary heart disease was 50.93%(55/108),and that in the control group was 34%(34/100).The positive rate of Hp in patients with coronary heart disease was higher than that in the control group(P<0.05).Among the Hp-positive patients in the case group,45 cases were type I infection and 10 cases were type II infection.Among that in the control group,22 cases were type I infection and 12 cases were type II infection.The difference in the positive rate of type I Hp between the two groups was statistically significant(P<0.05),while the difference in the positive rate of type II Hp was not statistically significant(P>0.05).The comparison of the proportions of single-vessel,two-vessel and three-vessel coronary artery lesions in patients with coronary heart disease with type IHp infection and type II Hp infection was not statistically significant(P>0.05).The comparison of the constituent ratios of single-vessel and three-vessel coronary artery lesions between Hp-positive patients and Hp-negative patients was statistically significant(P<0.05).The comparison of the constituent ratios of stable plaques,unstable plaques and soft plaques between Hp-positive patients and Hp-negative patients was statistically significant(P<0.05).The levels of TC,TG.LDL-C and HDL-C in Hp-positive patients with coronary heart disease were(5.07±0.64)mmol/L,(1.59±0.35)mmol/L,(3.34±0.56)mmol/L and(1.05±0.30)mmol/L respectively,and the levels of hs-CRP,TNF-αand IL-6 were(12.19±0.84)mg/L,(57.85±4.04)ng/L and(40.17±3.60)ng/L respectively.The levels of TC,TG,LDL-C and HDL-C in Hp-negative patients with coronary heart disease were(4.24±0.52)mmol/L,(1.25±0.33)mmol/L,(2.98±0.38)mmol/L and(1.19±0.30)mmol/L respectively.and the levels of hs-CRP,TNF-αand IL-6 were(9.07±0.81)mg/L,(40.14±4.18)ng/L,and(31.66±4.55)ng/L respectively.The differences in blood lipid levels and inflammatory factor levels between the two groups were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the comparison of various blood lipid levels between the combined treatment group and the conventional treatment group(P>0.05).After 6 months of treatment,the levels of TC,TG,LDL-C and HDL-C in the combined treatment group were(4.00±0.64)mmol/L.(1.28±0.38)mmol/L.(2.57±0.56)mmol/L and(1.40±0.31)mmol/L respectively,and those in the conventional treatment group were(4.62±0.54)mmol/L,(1.31±0.31)mmol/L,(3.12±0.60)mmol/L and(1.22±0.28)mmol/L respectively.The differences in the levels of TC,LDL-C and HDL-C between the two groups were statistically significant(P<0.05).Conclusion The infection rate of Hp in patients with coronary heart disease was higher than that in healthy people.The levels of blood lipids and inflammatory factors in Hp-positive patients were higher than those in Hp-negative patients.Hp infection may affect the lipid metabolism function of the human body and lead to the onset of coronary heart disease.Anti-Helicobacter pylori treatment for Hp-positive patients with coronary heart disease can effectively improve the treatment efficiency and the blood lipid levels of patients.