原发性高血压患者颈动脉粥样硬化、新发心脑血管事件与幽门螺旋杆菌感染的关系
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摘要
目的:研究原发性高血压(PH)患者颈动脉粥样硬化、新发心脑血管事件与幽门螺旋杆菌(HP)感染的关系。方法:选择从2015年6月到2017年6月在我院接受诊治的PH患者150例纳入本次研究。按照13C尿素呼气试验所测定的HP结果将患者分成HP阳性59例(即超基准值<4.0,记为观察组)和HP阴性91例(即超基准值≥4.0,记为对照组),检测并对比两组血脂指标、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)水平以及颈动脉超声检查结果,随访3个月,比较两组新发心脑血管事件。结果:与对照组比较,观察组的低密度脂蛋白型胆固醇(LDL-C)、Hcy及hs-CRP、甘油三酯(TG)、总胆固醇(TC)水平明显升高,高密度脂蛋白型胆固醇(HDL-C)水平明显降低(P<0.05)。观察组CIMT增厚率为28.82%,形成斑块率为49.15%,均分别高于对照组的15.38%、30.77%,而CIMT正常率为22.03%,明显低于对照组的53.85%,差异均有统计学意义(P<0.05)。观察组新发心脑血管事件的总发生率为13.56%,高于对照组的4.40%,差异有统计学意义(P<0.05)。结论:PH患者的颈动脉粥样硬化、新发心脑血管事件均与HP感染密切相关,临床可考虑清除或预防HP感染,从而科学有效地预防患者的不良预后。
Objective: To study the relationship between carotid atherosclerosis, new cardio cerebrovascular events and Helicobacter pylori(HP) infection in patients with primary hypertension(PH). Methods: 150 patients with PH who were treated in our hospital from June 2015 to June 2017 were selected and included in this study. The patient was divided into HP positive with 59 cases(excess reference value <4.0, recorded as observation group) and HP negative with 91 cases(excess reference value ≥4.0, recorded as control group) according to HP results determined by 13 C urea breath test. Blood lipids, hypersensitivity C reactive protein(hs-CRP),homocysteine(Hcy) levels and carotid ultrasound examination results were compared between the two groups, and followed up for 3 months, new cardio cerebrovascular events of two groups were compared. Results: Compared with control group, the levels of low density lipoprotein cholesterol(LDL-C), Hcy, hs-CRP, triglyceride(TG), total cholesterol(TC) in the observation group were significantly increased, the high density lipoprotein cholesterol(HDL-C) was significantly decreased(P<0.05). The thickening rate of CIMT in the observation group was 28.82%, and the plaque formation rate was 49.15%, which were respectively significantly higher than15.38%, 30.77% of the control group, the normal rate of CIMT was 22.03%, which was significantly lower than that of 53.85% in the control group, and the difference was statistically significant(P<0.05). The total incidence rate of new cardio cerebrovascular events in the observation group was 13.56%, which was significantly higher than 4.40% in the control group, the difference was statistically significant(P<0.05). Conclusion: Carotid atherosclerosis and new cardio cerebrovascular events in patients with PH are closely related to HP infection. Clinically, we should consider eliminating or preventing HP infection, so as to prevent the adverse prognosis of patients scientifically and effectively.
Objective: To study the relationship between carotid atherosclerosis, new cardio cerebrovascular events and Helicobacter pylori(HP) infection in patients with primary hypertension(PH). Methods: 150 patients with PH who were treated in our hospital from June 2015 to June 2017 were selected and included in this study. The patient was divided into HP positive with 59 cases(excess reference value <4.0, recorded as observation group) and HP negative with 91 cases(excess reference value ≥4.0, recorded as control group) according to HP results determined by 13 C urea breath test. Blood lipids, hypersensitivity C reactive protein(hs-CRP),homocysteine(Hcy) levels and carotid ultrasound examination results were compared between the two groups, and followed up for 3 months, new cardio cerebrovascular events of two groups were compared. Results: Compared with control group, the levels of low density lipoprotein cholesterol(LDL-C), Hcy, hs-CRP, triglyceride(TG), total cholesterol(TC) in the observation group were significantly increased, the high density lipoprotein cholesterol(HDL-C) was significantly decreased(P<0.05). The thickening rate of CIMT in the observation group was 28.82%, and the plaque formation rate was 49.15%, which were respectively significantly higher than15.38%, 30.77% of the control group, the normal rate of CIMT was 22.03%, which was significantly lower than that of 53.85% in the control group, and the difference was statistically significant(P<0.05). The total incidence rate of new cardio cerebrovascular events in the observation group was 13.56%, which was significantly higher than 4.40% in the control group, the difference was statistically significant(P<0.05). Conclusion: Carotid atherosclerosis and new cardio cerebrovascular events in patients with PH are closely related to HP infection. Clinically, we should consider eliminating or preventing HP infection, so as to prevent the adverse prognosis of patients scientifically and effectively.
引文
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[22]Xu Z,Li J,Wang H,et al.Helicobacter pylori infection and atherosclerosis:is there a causal relationship?[J].Eur J Clin Microbiol Infect Dis,2017,36(12):2293-2301
[23]Shan JH,Bai XJ,Han LL,et al.Changes with aging in gastric biomarkers levels and in biochemical factors associated with Helicobacter pylori infection in asymptomatic Chinese population[J].World J Gastroenterol,2017,23(32):5945-5953
[24]Jamkhande PG,Gattani SG,Farhat SA.Helicobacter pylori and cardiovascular complications:a mechanism based review on role of Helicobacter pylori in cardiovascular diseases[J].Integr Med Res,2016,5(4):244-249
[25]王国成,麻伟博,李娜,等.妊娠期高血压患者血清同型半胱氨酸水平与幽门螺杆菌感染相关性研究[J].中国实验诊断学,2017,21(4):604-606
[26]Kim TJ,Pyo JH,Lee H,et al.Lack of Association between Helicobacter pylori Infection and Various Markers of Systemic Inflammation in Asymptomatic Adults[J].Korean J Gastroenterol,2018,72(1):21-27
[27]Piroozmand A,Soltani B,Razavizadeh M,et al.Comparison of gastric juice soluble triggering receptor expressed on myeloid cells and C-reactive protein for detection of Helicobacter pylori infection[J].Electron Physician,2017,9(12):6111-6119
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[29]王龙,王复郁,赵学敏,等.脑卒中高危人群幽门螺杆菌感染与颈动脉粥样硬化进展关系的研究[J].中华神经科杂志,2016,49(10):780-784
[30]Jiang J,Chen Y,Shi J,et al.Population attributable burden of Helicobacter pylori-related gastric cancer,coronary heart disease,and ischemic stroke in China[J].Eur J Clin Microbiol Infect Dis,2017,36(2):199-212
[2]Guay CA,Morin-Thibault LV,Bonnet S,et al.Pulmonary hypertension-targeted therapies in heart failure:A systematic review and meta-analysis[J].PLoS One,2018,13(10):e0204610
[3]孙磊,孟锦,赵宏伟,等.不同剂量阿伐他汀联合阿司匹林治疗原发性高血压并动脉粥样硬化的临床研究[J].现代生物医学进展,201818(4):681-684
[4]Steffen BT,Bielinski SJ,Decker PA,et al.Low high-density lipoprotein cholesterol and particle concentrations are associated with greater levels of endothelial activation markers in Multi-Ethnic Study of Atherosclerosis participants[J].J Clin Lipidol,2017,11(4):955-963
[5]Ma S,Wang S,Li M,et al.The effects of pigment epithelium-derived factor on atherosclerosis:putative mechanisms of the process[J]Lipids Health Dis,2018,17(1):240
[6]Chen A,Sun Y,Cui J,et al.Associations of sclerostin with carotid artery atherosclerosis and all-cause mortality in Chinese patients undergoing maintenance hemodialysis[J].BMC Nephrol,2018,19(1)264
[7]Lee M,Baek H,Park JS,et al.Current Helicobacter pylori infection is significantly associated with subclinical coronary atherosclerosis in healthy subjects:A cross-sectional study[J].PLoS One,2018,13(3)e0193646
[8]Wang JW,Tseng KL,Hsu CN,et al.Association between Helicobacter pylori eradication and the risk of coronary heart diseases[J].PLoSOne,2018,13(1):e0190219
[9]Feige MH,Sokolova O,Pickenhahn A,et al.HopQ impacts the integrinα5β1-independent NF-κB activation by Helicobacter pylor in CEACAM expressing cells[J].Int J Med Microbiol,2018,308(5)527-533
[10]Xu Z,Li J,Wang H,et al.Helicobacter pylori infection and atherosclerosis:is there a causal relationship?[J].Eur J Clin Microbiol Infect Dis,2017,36(12):2293-2301
[11]Feige MH,Vieth M,Sokolova O,et al.Helicobacter pylori induces direct activation of the lymphotoxin beta receptor and non-canonical nuclear factor-kappa B signaling[J].Biochim Biophys Acta Mol Cell Res,2018,1865(4):545-550
[12]中国高血压防治指南修订委员会.中国高血压防治指南(2010年修订版)[J].中国实用乡村医生杂志,2012,19(12):1-15
[13]易月婵,李勤,徐宁,等.原发性高血压并发缺血性脑卒中与颈动脉粥样硬化的关系研究[J].中国实用神经疾病杂志,2016,19(2)43-44
[14]eker T,Türko lu C,Harbal覦o lu H,et al.Epicardial Fat Thickness is Associated with Abnormal Left Ventricle Geometry in Newly Diagnosed Hypertension[J].Acta Cardiol Sin,2018,34(3):280-287
[15]Richter MJ,Harutyunova S,Bollmann T,et al.Long-term safety and outcome of intravenous treprostinil via an implanted pump in pulmonary hypertension[J].J Heart Lung Transplant,2018,37(10)1235-1244
[16]Li C,Zhao J,He K,et al.Curative resolution of chronic thromboembolic pulmonary hypertension with pulmonary thromboendarterectomy in primary antiphospholipid syndrome:Acase report[J].Medicine(Baltimore),2018,97(40):e12710
[17]Sevencan NO,Ozkan AE.Renal resistive index and aortic knob width relationship as a predictor of renal prognosis in essential hypertension[J].Medicine(Baltimore),2018,97(40):e12434
[18]Xu L,Wang N,Chen X,et al.Quantitative evaluation of myocardial layer-specific strain using two-dimensional speckle tracking echocardiography among young adults with essential hypertension in China[J].Medicine(Baltimore),2018,97(39):e12448
[19]Shoji M,Takemoto M,Kobayashi K,et al.Serum podocalyxin levels correlate with carotid intima media thickness,implicating its role as a novel biomarker for atherosclerosis[J].Sci Rep,2018,8(1):245
[20]Lai CL,Xing JP,Liu XH,et al.Relationships of Inflammatory Factors and Risk Factors with Different Target Organ Damage in Essential Hypertension Patients[J].Chin Med J(Engl),2017,130(11):1296-1302
[21]朱伟群,张萍萍,孙涛,等.幽门螺杆菌感染与动脉粥样硬化的关系及危险因素研究[J].中华医院感染学杂志,2017,27(15):3460-3463
[22]Xu Z,Li J,Wang H,et al.Helicobacter pylori infection and atherosclerosis:is there a causal relationship?[J].Eur J Clin Microbiol Infect Dis,2017,36(12):2293-2301
[23]Shan JH,Bai XJ,Han LL,et al.Changes with aging in gastric biomarkers levels and in biochemical factors associated with Helicobacter pylori infection in asymptomatic Chinese population[J].World J Gastroenterol,2017,23(32):5945-5953
[24]Jamkhande PG,Gattani SG,Farhat SA.Helicobacter pylori and cardiovascular complications:a mechanism based review on role of Helicobacter pylori in cardiovascular diseases[J].Integr Med Res,2016,5(4):244-249
[25]王国成,麻伟博,李娜,等.妊娠期高血压患者血清同型半胱氨酸水平与幽门螺杆菌感染相关性研究[J].中国实验诊断学,2017,21(4):604-606
[26]Kim TJ,Pyo JH,Lee H,et al.Lack of Association between Helicobacter pylori Infection and Various Markers of Systemic Inflammation in Asymptomatic Adults[J].Korean J Gastroenterol,2018,72(1):21-27
[27]Piroozmand A,Soltani B,Razavizadeh M,et al.Comparison of gastric juice soluble triggering receptor expressed on myeloid cells and C-reactive protein for detection of Helicobacter pylori infection[J].Electron Physician,2017,9(12):6111-6119
[28]Vijayvergiya R,Vadivelu R.Role of Helicobacter pylori infection in pathogenesis of atherosclerosis[J].World J Cardiol,2015,7(3):134-143
[29]王龙,王复郁,赵学敏,等.脑卒中高危人群幽门螺杆菌感染与颈动脉粥样硬化进展关系的研究[J].中华神经科杂志,2016,49(10):780-784
[30]Jiang J,Chen Y,Shi J,et al.Population attributable burden of Helicobacter pylori-related gastric cancer,coronary heart disease,and ischemic stroke in China[J].Eur J Clin Microbiol Infect Dis,2017,36(2):199-212