目的:探讨不同基因型幽门螺杆菌(Hp)与冠心病的相关性.方法:将研究对象分为冠心病组(60例)和非冠心病组(对照组,60例),检测血浆中同型半胱氨酸(HCY)、C反应蛋白(CRP)水平,胃镜下取胃组织检测Hp,对Hp阳性者检测cagA基因.结果:冠心病组的Hp感染率(55% vs 30%,χ2=0.67,P＜0.01)及Hp阳性患者的细胞毒性相关基因(cagA)基因检出率(60.6% vs 27.8%,χ2=5.01,P＜0.05)显著高于对照组.冠心病组Hp阳性患者血浆HCY水平[(19.60±3.11)μmol/L]显著高于Hp阴性患者[(14.80±4.60)μmol/L](t=4.82,P＜0.001);cagA基因型患者血浆HCY水平[(22.61±4.98)μmol/L]显著高于非cagA基因型患者[(17.10±3.41)μmol/L](t=3.48,P＜0.001).cagA基因型患者血浆CRP水平[(4.98±2.02)mg/L]显著高于非cagA基因型患者[(2.06±1.00)mg/L](t=2.355,P＜0.05).结论:cagA基因型Hp感染,可增高血浆HCY和CRP水平,与冠心病的发生、发展相关.%Objective: To explore the correlation between different genotypes of Helicobacter pylori (Hp) and coronary heart disease. Methods: The subjects were divided into CHD group (60 cases) and non-CHD group (control group, 60 cases). Blood plasma HCY and CRP levels were examined. Hp in gastric tissue obtained from gastric endoscopy was examined, cagA gene were detected in Hp positive patients. Results: The HP infection rate (55% vs 30%,χ2=0.67, P<0.01) and the cagA gene detection rate in Hp positive patients (60.6% vs 27.8%, χ2=5.01, P<0.05) of the CHD group were significantly higher than that of the control group. In the CHD group, the plasma HCY level of the HP-positive patients [(19.60±3.11)μmol/L] was signifi cantly higher than that of the HP-negative patients [(14.80±4.60)μmol/L] (t=4.82, P<0.001), and the plasma HCY level of the cagA genotype patients [(22.61 ±4.98)μmol/L] was significantly higher than that of the patients with non-cagA genotype [(17.10±3.41)|μmol/L] (t=3.48, P<0.001). The CRP level of the cagA genotype patients [(4.98±2.02)mg/L] was significantly higher than those of the non-cagA genotype patients [(2.06±1.00)mg/L] (t=2.355,P<0.05). Conclusion: The infection of the cagA genotype Hp could increase the blood plasma HCY and CRP levels, which is related to development of coronary heart disease.
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