Hp感染对2型糖尿病患者炎症因子、胃肠激素及胰岛素抵抗的影响

摘要

目的 探讨幽门螺杆菌 (Hp) 感染对2型糖尿病患者炎症因子、胃肠激素及胰岛素抵抗的影响.方法 收集2014年5月至2016年10月该院收治86例2型糖尿病患者作为研究对象, 患者入院后均实施13 C尿素呼气试验, 依据试验结果将46例2型糖尿病伴有Hp感染者作为观察组和2型糖尿病无Hp感染者作为对照组, 比较两组炎症因子超敏C反应蛋白 (hs-CRP) 、血清白细胞介素6 (IL-6) 、肿瘤坏死因子-α (TNF-α) 和胃肠激素血清胃泌素 (GAS) 、生长抑素 (SS) 及空腹血糖 (FPG) 、空腹胰岛素 (FINS) 、胰岛素抵抗指数 (HOMA-IR) , 并探讨各观察指标与Hp感染相关性分析性.结果 观察组hs-CRP、IL-6、TNF-α、GAS水平及FPG、FINS、HOMA-IR较对照组明显高, 而SS较对照组明显降低, 差异有统计学意义 (P<0.05);经进一步Sperman相关性分析显示hs-CRP、IL-6、TNF-α、GAS、FINS、HOMA-IR与Hp感染呈明显正相关 (r=0.452、0.350、0.398、0.389、0.421、0.568, P<0.05) , SS与Hp感染呈明显负相关 (r=-0.401, P<0.05) .结论 Hp感染与2型糖尿病患者炎性反应、胃肠激素紊乱和胰岛素抵抗紧密相关, 临床据此为患者实施合理的防治措施是延缓2型糖尿病疾病进展和恶化的关键.%Objective To investigate the effect of Hp infection on the inflammatory factors, gastrointestinal hormones and insulin resistance in patients with type 2diabetes mellitus.Methods A total of 86patients with type 2diabetes mellitus treated in a hospital from May 2014to October 2016were enrolled in the study.All patients underwent 13C urea breath test after admission, and according to the test results, patients were divided into the observation group, which was type 2diabetes mellitus with Hp infection (n=46) and the control group, which was type 2diabetes mellitus without Hp infection (n=40) .Inflammatory factors such as highsensitivity C reactive protein (hs-CRP) , serum interleukin 6 (IL-6) , tumor necrosis factorα (TNF-α) , gastrointestinal hormones such as serum gastrin (GAS) , somatostatin (SS) and fasting blood glucose (FPG) , fasting insulin (FINS) , insulin resistance index (HOMA-IR) were compared between the two groups, and the correlation of the observation indicators with Hp infection was explored.Results Levels of hs-CRP, IL-6, TNF-αand GAS, FPG, FINS and HOMA-IR in the observation group were significantly higher than those in the control group, while SS was significantly lower than that in the control group, the difference was statistically significant (P<0.05) .Further Sperman correlation analysis showed that hs-CRP, IL-6, TNF-α, GAS, FINS and HO-MA-IR were positively correlated with Hp infection (r=0.452, 0.350, 0.398, 0.389, 0.421, 0.568, P<0.05) , and SS was negatively correlated with Hp infection (r=-0.401, P<0.05) .Conclusion Hp infection is closely related to inflammatory reactions, gastrointestinal hormone disorders and insulin resistance in patients with type 2diabetes mellitus, and taking reasonable preventive measures is the key to delay the progression and deterioration of type 2diabetes mellitus.