抗幽门螺杆菌治疗对颈动脉斑块患者血脂、颈动脉形态和血流动力学的影响
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摘要
目的:观察抗幽门螺杆菌(Hp)治疗对颈动脉斑块患者血脂和颈动脉形态和血流动力学的影响。方法:选取2017-12—2018-06于我院就诊的颈动脉斑块患者268例,根据数字随机法,将Hp感染合并颈动脉斑块患者分为A组和B组,每组134例;2组均给予常规降脂药和阿司匹林药物治疗,B组在A组基础上加用抗Hp治疗,于治疗前、后分别检测2组患者的血脂、颈动脉形态及血流动力学指标的变化情况。结果:2组患者的年龄、性别、心率、体质指数(BMI)、血压、血糖及肝肾功能均无明显差异(P>0.05),治疗前IMT、动脉内径、血流动力学和血脂水平亦无明显差异(P>0.05),治疗后IMT和动脉内径明显减少,而血流动力学指标和血脂水平得到明显改善(P<0.05),但B组降低和改善的程度更明显(P<0.05)。结论:高血压患者抗Hp治疗可更好地改善患者血脂、颈动脉形态和血流动力学参数异常。
Objective:To observe the effect of anti-Helicobacter pylori(Hp) on blood lipid,carotid morphology and hemodynamics in patients with carotid plaque.Method:A total of 268 patients with carotid plaque who were treated in our hospital from June 2017 to May 2018.According to the digital randomization method,patients with Hp infection and carotid plaque were divided into A and B groups.134 cases of each group,both groups A and B were given conventional lipid-lowering drugs and aspirin drugs,and group B was treated with anti-Hp in base of group A.Blood lipids,carotid morphology and hemodynamic parameters were measured before and after treatment.Result:There were no significant differences in age,heart rate,BMI,blood pressure,fasting glucose liver and renal function between the two groups(P>0.05).There was no significant difference in IMT,arterial diameter,hemodynamics and blood lipid levels between the two groups(P>0.05).After treatment,both IMT and arterial diameter were significantly reduced,hemodynamic parameters and blood lipid levels were significantly improved(P<0.05),but the reduction and improvement of group B were more significant(P<0.05).Conclusion:Anti-Hp treatment in patients with hypertension can improve the abnormalities of blood lipids,carotid morphology and hemodynamic parameters.
Objective:To observe the effect of anti-Helicobacter pylori(Hp) on blood lipid,carotid morphology and hemodynamics in patients with carotid plaque.Method:A total of 268 patients with carotid plaque who were treated in our hospital from June 2017 to May 2018.According to the digital randomization method,patients with Hp infection and carotid plaque were divided into A and B groups.134 cases of each group,both groups A and B were given conventional lipid-lowering drugs and aspirin drugs,and group B was treated with anti-Hp in base of group A.Blood lipids,carotid morphology and hemodynamic parameters were measured before and after treatment.Result:There were no significant differences in age,heart rate,BMI,blood pressure,fasting glucose liver and renal function between the two groups(P>0.05).There was no significant difference in IMT,arterial diameter,hemodynamics and blood lipid levels between the two groups(P>0.05).After treatment,both IMT and arterial diameter were significantly reduced,hemodynamic parameters and blood lipid levels were significantly improved(P<0.05),but the reduction and improvement of group B were more significant(P<0.05).Conclusion:Anti-Hp treatment in patients with hypertension can improve the abnormalities of blood lipids,carotid morphology and hemodynamic parameters.
引文
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[16] 王文荣,熊开宇,何辉,等.血压对非动脉粥样硬化中年人颈动脉形态、血流动力学的影响[J].中国动脉硬化杂志,2018,26(1):60-64.
[17] Peiffer V,Sherwin SJ,Weinberg PD,et al.Does low and oscillatory wall shear stress correlate spatially with early atherosclerosis? A systematic review[J].Cardiovasc Res,2013,99(2):242-250.
[2] 张广波,于凯,冀瑞俊,等.河北省任丘市城乡老年居民颈动脉斑块特征与心脑血管事件的相关性研究[J].中国基层医药,2016,23(1):95-101.
[3] 刘博罕,穆洋,李延广,等.年龄对颈动脉形态特征及颈动脉斑块的影响[J].中华老年心脑血管病杂志,2016,18(5):460-463.
[4] 郭晓斌,王鹏,陶立元,等.颈动脉粥样斑块形成的影响因素研究[J].中国全科医学,2018,21(17):2043-2047.
[5] 金红,王寒梅,庞利,等.老年人群颈动脉斑块的相关危险因素[J].中华老年医学杂志,2016,35(10):1075-1078.
[6] 陈晶,付娟,刘娜,等.幽门螺杆菌感染对冠心病患者相关指标及颈动脉硬化的影响[J].中华医院感染学杂志,2016,26(13):2972-2974.
[7] Hu KC,Wu MS,Chu CH,et al.Hyperglycemia combined Helicobacter pylori infection increases risk of synchronous colorectal adenoma and carotid artery plaque[J].Oncotarget,2017,8(65):108655-108664.
[8] 高瑞臣.中老年人颈动脉硬化斑块与缺血性脑血管病相关性分析[J].中西医结合心脑血管病杂志,2016,14(17):2061-2063.
[9] 秦海强,王拥军.局部血液动力学与颈动脉粥样硬化性斑块[J].中国卒中杂志,2008,3(1):65-69.
[10] 沈琳,高海青,由倍安,等.老年人颈动脉斑块形态学特点与心血管危险因素的相关性研究[J].中华老年医学杂志,2011,30(4):265-268.
[11] 李霞,于红霞,于秀萍.老年脑梗死合并颈动脉粥样硬化患者幽门螺杆菌感染及与证候的相关性[J].中国老年学杂志,2015,35(22):6433-6434.
[12] 龚兰生.中国血管病变早期检测技术应用指南(第一次报告)[J].中国民康医学杂志,2006,18(5):323-331.
[13] 王黎,张源明,陈曦,等.原发性高血压患者踝臂动脉脉搏波传导速度与中心动脉压及颈动脉内膜厚度的相关性[J].临床心血管病杂志,2015,31(2):159-162.
[14] 杨志军.颈动脉粥样硬化斑块生长部位及血管内膜厚度对血流动力学的影响[J].临床医学研究与实践,2016,1(13):40-40.
[15] 王慧琴,王思博,刘亢丁,等.局部血液动力学对颈动脉粥样硬化斑块的影响[J].中风与神经疾病,2017,34(7):667-669.
[16] 王文荣,熊开宇,何辉,等.血压对非动脉粥样硬化中年人颈动脉形态、血流动力学的影响[J].中国动脉硬化杂志,2018,26(1):60-64.
[17] Peiffer V,Sherwin SJ,Weinberg PD,et al.Does low and oscillatory wall shear stress correlate spatially with early atherosclerosis? A systematic review[J].Cardiovasc Res,2013,99(2):242-250.