不同类型幽门螺杆菌感染对老年冠心病患者炎症因子及血脂水平的影响

Effect of infection of different types of Helicobacter pylori on lipid profiles and inflammatory factors in the elderly with coronary heart diseases

摘要:

目的 探讨不同类型幽门螺杆菌(H.pylori)感染对老年冠心病患者炎症因子及血脂水平的影响。方法 选取2016年1月至2018年6月就诊于合肥市第五人民医院消化内科行¹⁴C尿素呼气试验、H.pylori抗体分型测定的142例老年冠心病患者。根据H.pylori分型将患者分为Ⅰ型H.pylori感染组(n=41)、Ⅱ型H.pylori感染组(n=33)和H.pylori阴性组(n=68)。记录患者入院时冠状动脉病变程度,收集空腹静脉血,测定总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和IL-8的含量。采用SPSS 23.0统计软件对数据进行分析。根据数据类型,组间比较采用单因素方差分析、LSD两两比较、χ²检验或线性趋势检验。结果 3组患者hs-CRP、IL-6、IL-8、TNF-α两两比较,差异均有统计学意义(P<0.05)；与H. pylori阴性组比较,Ⅰ型和Ⅱ型H.pylori感染组患者的TC、LDL-C显著升高,Ⅰ型H.pylori感染组患者的HDL-C显著降低(P<0.05)；与Ⅱ型H.pylori感染组比较,Ⅰ型H.pylori感染组LDL-C显著升高,HDL-C显著降低(P<0.05)。H.pylori阴性组单支、2支及3支冠状动脉病变比例依次为66.2%(45例)、17.6%(12例)、16.2%(11例),Ⅰ型H.pylori感染组上述比例为19.5%(8例)、36.6%(15例)和43.9%(18例),Ⅱ型H.pylori感染组上述比例为36.4%(12例)、30.3%(10例)和33.3%(11例),线性趋势检验显示,3组患者冠状动脉病变程度内部构成之间比较差异有统计学意义(χ²=20.79,P<0.001)。结论 H.pylori感染尤其Ⅰ型感染与老年冠心病患者的炎症因子水平增加、血脂紊乱加剧有关。

Abstract:

Objective To investigate the effect of different types of Helicobacter pylori (H.pylori) on lipid profiles and inflammatory factors in the elderly patients with coronary heart diseases (CHD). Methods A total of 142 elderly CHD patients admitted in our department from January 2016 to June 2018 were enrolled in this study. The patients underwent ¹⁴C-urea breath test and H.pylori antibody classification, and were then divided into 3 groups:type Ⅰ H.pylori infection group (n=41), type Ⅱ H.pylori infection group (n=33), and H.pylori negative group (n=68). The severity of coronary artery lesion was recorded at admission. Fasting venous blood samples were collected for the levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-8. SPSS statistics 23.0 was used to analyze the data. According to the data types, One-way ANOVA, LSD test, Chi-square test, or linear trend test was used for intergroup comparison. Results There were significant diffe-rences in the levels of hs-CRP, IL-6, IL-8 and TNF-α among the 3 groups (P<0.05). Compared with H.pylori negative group, the type Ⅰand Ⅱ H.pylori infection groups had significantly higher TC and LDL-C level, while the former group also had obviously lower HDL-C (P<0.05). The LDL-C level was markedly higher while that of LDL-C were reduced in the type Ⅰ H.pylori infection group than the type Ⅱ H.pylori infection group (P<0.05). In H.pylori negative group, the proportions of single, 2 and 3 coronary artery lesions accounted for 66.2%(45 cases), 17.6%(12 cases) and 16.2%(11 cases), respectively. While the proportions above were 19.5%(8 cases), 36.6%(15 cases) and 43.9%(18 cases) in type Ⅰ H.pylori infection group, and 36.4%(12 cases), 30.3%(10 cases) and 33.3%(11 cases) in type Ⅱ H.pylori infection group. Linear trend test showed that there were significant differences in internal composition of the severity of coronary artery lesion among the 3 groups (χ²=20.79, P<0.001). Conclusion H.pylori infection, especially that of type I, is associated with increased levels of inflammatory factors and deterioration of dyslipidemia in elderly CHD patients.