幽门螺杆菌感染与老年冠心病患者LBP、MMP⁃9水平的相关性

Correlation between Helicobacter pylori infection and LBP and MMP⁃9 levels in elderly patients with coronary heart disease

目的分析幽门螺杆菌(Hp)感染与老年冠心病患者脂多糖结合蛋白(LBP)、基质金属蛋白酶-9(MMP⁃9)水平的相关性。方法回顾性分析2020年1月-2023年1月期间广安市人民医院纳入的284例老年冠心病患者,根据Hp检测结果将其分为Hp阳性组(n=163)、Hp阴性组(n=121),将Hp阳性组根据血液Hp抗体浓度分为高浓度组(Hp抗体水平>198 ng/L,n=74)、低浓度组(Hp抗体水平≤198 ng/L,n=89),比较3组患者LBP、MMP⁃9水平,分析LBP、MMP⁃9水平与老年冠心病合并Hp感染患者血液Hp抗体水平的相关性。以是否发生不良心血管事件作为预后评估标准将284例患者分为预后不良组(n=125)、预后良好组(n=159),比较两组患者LBP、MMP⁃9水平和Hp感染阳性率,采用受试者工作特征(ROC)曲线分析LBP、MMP⁃9水平、Hp感染联合检测预测老年冠心病患者预后不良的价值。结果高浓度组、低浓度组LBP、MMP⁃9水平高于Hp阴性组,差异均有统计学意义(t=27.529、15.808,15.939、11.409,P均<0.001),高浓度组LBP、MMP⁃9水平高于低浓度组,差异均有统计学意义(t=7.619、4.321,P均<0.001);3组间LBP、MMP⁃9水平比较差异亦有统计学意义(F=287.232、126.014,P均<0.001)。经Pearson分析,LBP、MMP⁃9水平与老年冠心病合并Hp感染患者血液Hp抗体水平成正相关(r=0.845、0.623,P均<0.05)。预后不良组LBP、MMP⁃9水平及Hp感染阳性率高于预后良好组,差异均有统计学意义(t/χ^(2)=5.503、4.586、17.402,P均<0.001)。LBP、MMP⁃9水平及Hp感染联合检测预测老年冠心病患者预后不良的曲线下面积(AUC)为0.741,敏感度为74.40%,特异度为67.30%。结论Hp感染与老年冠心病患者LBP、MMP⁃9水平密切相关,LBP、MMP⁃9水平联合Hp感染对老年冠心病患者预后不良有一定的预测价值。

Objective To analyze the correlation of Helicobacter pylori(Hp)infection with levels of lipopolysaccharide binding protein(LBP)and matrix metalloproteinase⁃9(MMP⁃9)in elderly patients with coronary heart disease.Methods Retrospective analysis was performed on 284 elderly patients with coronary heart disease in the Guang'an People's Hospital from January 2020 to January 2023,and the patients were divided into Hp⁃positive group(n=163)and Hp⁃negative group(n=121)according to the Hp detection results of breath test.The patients in Hp⁃positive group were classified into high concentration group(Hp antibody level>198 ng/L,n=74)and low concentration group(Hp antibody level≤198 ng/L,n=89)by means of blood Hp antibody concentration.The levels of LBP and MMP⁃9 were compared among the three groups,and the correlation between the levels of LBP,MMP⁃9 and blood Hp antibody level was analyzed among elderly patients with coronary heart disease complicated with Hp infection.A total of 284 patients were assigned as poor prognosis group(n=125)and good prognosis group(n=159)based on the occurrence of adverse cardiovascular events as prognosis evaluation criteria,and the levels of LBP and MMP⁃9 and positive rate of Hp infection were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the combination of LBP,MMP⁃9 and Hp infection on poor prognosis in elderly patients with coronary heart disease.Results The levels of LBP and MMP⁃9 in high concentration group and low concentration group were higher than those in Hp⁃negative group(t=27.529,15.808;15.939,11.409;all P<0.001),and the levels of LBP and MMP⁃9 in high concentration group were higher compared with those in low concentration group(t=7.619,4.321;both P<0.001).The levels of LBP and MMP⁃9 were also significantly different among the three groups(F=287.232,126.014;both P<0.001).Pearson analysis showed LBP and MMP⁃9 levels were positively correlated with blood Hp antibody level in elderly patients with coronary heart disease complicated with Hp infection(r=0.845,0.623;both P<0.05).The levels of LBP,MMP⁃9 and positive rate of Hp infection were higher in poor prognosis group than those in good prognosis group(t/χ^(2)=5.503,4.586,17.402;all P<0.001).The area under curve(AUC),sensitivity and specificity of LBP and MMP⁃9 combined with Hp infection on predicting poor prognosis in elderly patients with coronary heart disease were 0.741,74.40%and 67.30%,respectively.Conclusions Hp infection was closely related to LBP and MMP⁃9 levels in elderly patients with coronary heart disease.The levels of LBP and MMP⁃9 combined with HP infection had certain predictive value for poor prognosis of elderly patients with coronary heart disease.