细胞毒素相关基因蛋白A抗体阳性幽门螺杆菌感染与急性冠状动脉综合征患者发病的关系研究

摘要

Objective To investigate the correlation between cytotoxin-associated gene A protein(CagA)-antibody-positive helicobaeter pylori (Hp) infection and acute coronary syndrome (ACS).Methods Totally 170 patients with ACS were enrolled from March 2015 to October 2016 in Civil Aviation General Hospital.According to results of coronary angiography,the patients were divided into ACS group(112 cases) and non-coronary heart disease(non-CHD) group(58 cases).Antibody profile of Hp was detected by immunoblotting technique.Serum levels of high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),total cholesterol (TC),homocysteine,uric acid and C-reactive protein were tested.Hp-positive patients were divided into CagA-antibody-positive group and CagA-antibody-negative group.Risk factors of ACS were analyzed.Results The Hppositive rate in 170 patients was 70.0％ (119/170);the CagA-antibody-positive rate was 51.2％ (87/170).Proportions of male and smoking in ACS group were significantly higher than those in non-CHD group,the level of HDL-C in ACS group was significantly lower than that in non-CHD group[66.1％ (74/112) vs 58.6％ (34/58),51.8％ (58/112) vs 20.7％ (12/58),(1.2 ± 0.3) mmol/L vs (1.3 ± 0.3) mmol/L] (P ＜ 0.05).The prevalence rate of ACS in CagA-antibody-positive group(87 cases) was significantly higher than that in CagA-antibody-negative group(83 cases)[73.6％ (64/87) vs 57.8％ (48/83)] (P ＜ 0.05).After adjustments of age,sex,hypertension,diabetes,smoking history,family history,TC,HDL-C and LDL-C,CagA-antibody-positive Hp infection showed positively correlation with ACS(P =0.037).Conclusion CagA-antibody-positive Hp infection is positively associated with ACS.%目的 探讨细胞毒素相关基因蛋白A(CagA)抗体阳性幽门螺杆菌(Hp)感染与急性冠状动脉综合征(ACS)发病的关系.方法 选取2015年3月至2016年10月于民航总医院心血管内科住院拟诊为ACS的患者170例,根据冠状动脉造影检查结果分为ACS组(112例)和非冠心病组(58例).免疫印迹法测定患者的Hp抗体谱,并同步测定高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇、同型半胱氨酸、血尿酸、C反应蛋白等,并加以比较.Hp阳性患者根据CagA状态又可分为CagA抗体阳性组和CagA抗体阴性组,进行组间比较.采用多元Logistic回归分析ACS发病的危险因素.结果 总人群的Hp阳性率为70.0％ (119/170),CagA抗体阳性率为51.2％ (87/170).ACS组男性、吸烟比例高于非冠心病组,HDL-C低于非冠心病组,差异有统计学意义[66.1％ (74/112)比58.6％(34/58)、51.8％(58/112)比20.7％(12/58)、(1.2±0.3)mmol/L比(1.3±0.3)mmol/L] (P＜0.05).CagA抗体阳性组ACS患病率明显高于CagA抗体阴性组[73.6％ (64/87)比57.8％ (48/83)] (P ＜0.05).校正年龄、性别、高血压、糖尿病、吸烟史、家族史、总胆固醇、HDL-C、LDL-C后,CagA抗体阳性的Hp感染与ACS发病呈明显正相关(P =0.037).结论 CagA抗体阳性Hp感染与ACS发病呈正相关.