冠心病患者幽门螺杆菌感染与C反应蛋白、血脂相互关系的研究

目的探讨冠心病(CHD)患者幽门螺杆菌(Hp)感染与C反应蛋白(CRP)、血脂的相互关系,探讨其可能的发病机制。方法对2004年3月至2005年1月深圳市罗湖区人民医院心内科收治的70例CHD患者,按临床诊断分为2组,采用酶联免疫吸附试验(ELISA)法检测急性心肌梗死(AMI)组、心绞痛(AP)组及对照组患者各35例外周血Hp抗体(HpIgG),同时测定血脂及CRP。结果AMI组、AP组及对照组血清HpIgG抗体阳性率分别为54.3%、45.7%及25.7%,AMI组、AP组分别与对照组比较差异有统计学意义(P<0.05),但AMI组与AP组间比较差异无统计学意义;血清CRP及血脂总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(apoA)AMI组、AP组显著高于对照组(P<0.01),而高密度脂蛋白胆固醇(HDL-C)AMI组、AP组显著低于对照组(P<0.01),AMI组也明显低于AP组(P<0.01);Hp感染者HpIgG水平与血中CRP、TG、LDL-C及apoA有明显相关性(r分别为0.44、0.64、0.36和0.32),而与HDL-C成负相关(r=-0.78)(P<0.01)。结论CHD患者Hp感染率明显增高,Hp可能通过炎症反应及影响脂质代谢在CHD的发生、发展中起作用。

The relationship between Hp infection and serum lipid or CRP levels in patients with CHD

Objective To investigate the relationship between helicobacter pylori(Hp) infection and serum lipid or C-reactive protein(CRP) levels in patients with coronary heart disease(CHD).Methods Serum specific antibodies to Hp(Hp IgG),serum lipid and CRP were measured in healthy subjects(control group,n=35) and patients with CHD,including patients with acute myocardial infarction(AMI group,n=35) and angina pectoris(AP group,n=35).Results The positive rate of Hp IgG was 54.3% in AMI group,45.7 % in AP group and 25.7% in control group,The positive rate of Hp IgG was significantly higher in patients with AMI or AP than in control group(P<0.05).Serum CRP,total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),apolipoprotein A(apo A) were significantly higher in patients with CHD than in control group(all P<0.01),while high density lipoprotein cholesterol(HDL-C) was significantly lower in patients with CHD than in control group(P<0.01),HDL-C was significantly lower in patients with AMI than in patients with AP(P<0.01).Hp IgG was positively correlated with CRP,TG,LDL-C and apo A(r=0.44,0.64,0.36 and.32,respectively) but negatively correlated with HDL-C in patients with CHD(r=-0.78,P<0.01).Conclusion Hp infection rate is significantly higher in patients with CHD.Hp infection may play a role in the pathogenesis of CHD through inflammatory reaction and lipid metabolic disturbance.