摘要
目的 :探讨幽门螺杆菌 (HP)及其不同毒力菌株感染与急性冠脉综合征 (ACS)发病的关系。方法 :应用免疫印迹法 (IBT)检测了 6 1例ACS患者及 5 7例对照者的血清特异性IgG抗体 (HP -IgG)、抗体亚型及血脂水平。结果 :ACS组血清HP -IgG阳性率为 86 .9% ,显著高于对照组的 6 8.4 % (OR :1.87,95 %CI∶1.0 7～ 3.2 8,χ2 =5 .85 ,P =0 .0 16 ) ;对HP -IgG阳性者的分型显示 :含有细胞毒素相关基因A(CagA)的强毒力Ⅰ型菌株与不含CagA的低毒力Ⅱ型菌株在ACS组与对照组间显著差异 (P <0 .0 5 )。HP -IgG阳性组血清TCH ,TC ,HDL及LDL与阴性组比较无显著性差异 (P >0 .0 5 )。结论 :HP感染与ACS发病显著相关 ,但强毒力的Ⅰ型菌株感染并未增加ACS发病的危险性。HP致ACS并非通过血脂改变而实现。
Objective:To investigate the relation between Helicobacter pylori(HP) infection and acute coronary syndrome(ACS) and to determine if potentially virulent strains of HP are more strongly related to ACS than other strains.Methods:We used immunoblot(IBT) method to measure serum IgG antibodies to mixed HP antigens and separately to the virulence-associated HP antigen CagA (cytotoxin-associated gene product A) in 61 patients with ACS and in 57 control subjects for whom there was no evidence of coronary artery disease tested by coronary arteriongraphy or/and intravascular unltrasound, carefully matched both for age and sex. Meanwhile, the serum concentrations of total cholesterol(TCH),triglyceride(TG) , low density lipoprotein(LDL) and high density lipoprotein(HDL) were measured in all subjects.Results: Of the 61 cases, 53 (86.9%) were seropositive for HP compared with 39 of the 57 controls (68.4%) (OR:1.87 , 95% CI:1.07～3.28,χ 2=5.85, P =0.016). The I type HP strains (contain CagA antigen ) were 34 in 53 HP positive ACS patients and 20 in 39 HP positive controls, and there was no significant difference between the two groups( P >0.05). No strong associations were found between HP seropositivity and blood lipids( P >0.05).Conclusion: HP infection is strongly related to the incidence of ACS, but the CagA-positive virulent strains appear to be no more strongly related to the disease than other strains. HP infection may not act through changes in lipid metabolism contributing to the pathogenesis of ACS.
出处
《中国现代医学杂志》
CAS
CSCD
2002年第12期28-29,32,共3页
China Journal of Modern Medicine
