摘要
目的 探讨幽门螺杆菌（Hp）感染对颈动脉粥样硬化患者血清脂蛋白相关磷脂酶A2（Lp-PLA2）水平、颈动脉内膜中层厚度（IMT）以及斑块稳定性的影响.方法 选取在本院行颈动脉彩超提示颈动脉粥样硬化的患者393例,均知情同意,用14C尿素呼气试验检测入选对象的Hp感染情况,同时采用酶联免疫吸附法测定其血清Lp-PLA2水平.GE Logic E9彩色超声诊断系统检测其IMT.结果 颈动脉粥样硬化患者中Hp感染者血清Lp-PLA2水平和颈动脉IMT高于非Hp感染者,且随着患者体内Hp感染程度的加重,其血清Lp-PLA2水平及颈动脉IMT亦相应增高;Hp不同感染程度分组血清Lp-PLA2水平及颈动脉IMT差异均具有统计学意义（P＜0.01）;在颈动脉粥样硬化并有斑块的患者中,Hp感染组不稳定斑块的发生率明显高于非Hp感染组,差异具有统计学意义（x2=4.744,P=0.029）;多因素分析显示：在斑块性颈动脉粥样硬化患者中,Hp感染者并发不稳定性斑块可能性是非Hp感染者的1.82倍,血清Lp-PLA2每升高1μg/L,发生不稳定性斑块的可能性增加2％.结论 Hp感染可能通过升高血清Lp-PLA2水平和改变动脉粥样硬化斑块的稳定性而促进动脉粥样硬化的发生和进展.
Objective To explore the influence of Helicobacter pylori （Hp） infection in serum lipoprotein associated phospholipase A2 （Lp-PLA2）, carotid intima-media thickness and stability of atherosclerotic plaques in atherosclerosis patients.Methods A total of 393 cases of patients with carotid artery arteriosclerosis confirmed by carotid color uhrasonography, who are informed consent, was selected as objects.The14C urea breath test was used to determine the infection situation of selected objects of helicobacter pylori.Meanwhile, enzyme-linked immunosorbent assay （ELISA） was used to determine the level of serum lipoprotein associated phospholipase A2 （Lp-PLA2）.Results Serum Lp-PLA2 levels and carotid intimamedia thickness （IMT） of patients with carotid artery atherosclerosis in Hp infection group were higher than that of Hp non-infection group, and with the degree of Hp infection aggravating in the patients of carotid artery atherosclerosis, their serum Lp-PLA2 levels and carotid IMT were also increased accordingly.F test showed that the differences of serum Lp-PLA2 levels and carotid IMT in different degree of carotid artery atherosclerosis group were statistically significant （P 〈0.01）.The incidence of unstable plaque of Hp infection group was obviously higher than that of the Hp non-infection group in the carotid atherosclerosis with plaques with statistical significance （chi square value =4.744, P =0.029）.Multivariate linear regression analysis showed that the possibility of complication of unstable plaques in Hp infection group of carotid artery atherosclerosis was 1.82 times than that of non-infection group.With serum Lp-PLA2 every increasing 1 μg/L, the possibility of instability plaque increased by 2%.Conclusions Hp infection may promote the occurrence and development of carotid artery atherosclerosis by increasing serum level of Lp-PLA2 and changing the stability of atherosclerotic plaques.
出处
《中国医师杂志》
CAS
2015年第10期1505-1508,共4页
Journal of Chinese Physician
基金
基金项目：湖南省卫生厅医药卫生科技计划课题资助项目（B2013-146）
