代谢综合征合并幽门螺杆菌感染与颈动脉内膜—中层厚度的相关性

发布时间：2018-07-12 18:17

  本文选题：代谢综合征 + 幽门螺杆菌　； 参考：《山东大学》2017年硕士论文

【摘要】：研究目的探讨代谢综合征(MS)、幽门螺杆菌(Hp)感染与颈动脉内膜-中层厚度(CIMT)的关系,进一步分析MS的各组分、Hp感染的交互作用与CIMT的关系。探寻颈动脉粥样硬化(CAS)的危险因素,进而为心脑血管疾病的防治提供理论线索。研究方法选取2015年度在山东大学齐鲁医院查体中心体检人员,通过内科问诊、生化检查、C-13呼气试验以及颈动脉彩超等方式收集体检人员的Hp感染、CIMT、空腹血糖、血脂、血压等相关信息。采用STATA 13.0软件对收集的数据进行分析。应用有序多分类Logistic回归分析MS及其各组分、Hp感染及其交互作用与颈动脉内膜-中层厚度的相关性。研究结果1.共纳入符合条件的调查研究对象2279例,其中男性1439例,女性840例,年龄在20-80岁之间。男性颈动脉斑块形成的检出率均高于女性(60.9%VS46.4%)。各年龄组间CIMT差异具有统计学意义(P0.05)。2.1ogistic回归分析结果显示,MS患者的颈动脉斑块的检出率高于非MS患者(71.4%VS53.6%),OR=1.50(95%CI:1.10～2.04)。Hp感染与颈动脉内膜-中层厚度变化的相关性无统计学意义OR=1.04(95%CI:0.87-1.25)。MS合并Hp感染患者的颈动脉斑块形成的发生率(73.8%)高于正常组(53.4%)、单纯MS 组(68.2%)以及单纯Hp感染组(53.7%),OR=1.74(95%CI:1.14～2.67)。3.高尿酸血症组颈动脉斑块形成的发生率高于正常组(67.0%VS 54.60%),OR=1.69(95%CI:1.19～2.3)。高血压组颈动脉斑块形成的检出率高于正常组(71.90%VS44.80%),OR=1.78(95%CI:1.46～2.18)。高血糖或(和)糖尿病组的颈动脉斑块形成的检出率高于正常组(77.0%VS 52.90%)OR=1.83(95%CI:1.31～2.57)。其它代谢综合征的组分与颈动脉内膜-中层厚度变化无相关性。4.根据性别进行分层分析后,女性人群中高尿酸血症、MS与CIMT的相关性无统计学意义,且Hp感染合并MS与CIMT的相关性也无统计学意义。无论男性还是女性,Hp感染合并高血糖或(和)糖尿病与CIMT的相关性均无统计学意义。根据年龄分层后,对于≤45岁和≥60岁的人群而言,高血糖或(和)糖尿病与颈动脉内膜-中层厚度变化的相关性无统计学意义。研究结论1.MS可能是CAS的危险因素,Hp感染与CAS的发生没有统计学相关性,当MS合并Hp感染时,CAS检出率增高。2.高尿酸血症、高血压可能是CAS的危险因素,且合并Hp感染对CIMT变化具有协同作用。高血压以及高尿酸血症患者应尤其注意CAS的预防。3.高血糖或(和)糖尿病与CIMT密切相关,BMI、TG、HDL-C可能不是CAS危险因素。
[Abstract]:Objective to investigate the relationship between metabolic syndrome (MS), Helicobacter pylori (HP) infection and carotid intima-media thickness (CIMT). To explore the risk factors of carotid atherosclerosis (CAS) and provide theoretical clues for the prevention and treatment of cardiovascular and cerebrovascular diseases. Methods Medical examiners from Qilu Hospital of Shandong University in 2015 were selected to collect HP infection with CIMT, fasting blood glucose and blood lipids by means of internal examination, biochemical examination and C-13 breath test. Blood pressure and other related information. The collected data were analyzed by STATA 13.0 software. The relationship between carotid intima-media thickness (IMT) and MS infection and its interaction with MS and its components were analyzed by logistic regression analysis. Results 1. A total of 2279 eligible subjects were included, including 1439 males and 840 females aged 20 to 80 years. The positive rate of carotid plaque formation in male was higher than that in female (60.9 vs 46.4%). The CIMT difference among different age groups was statistically significant (P0.05) .2.1 logistic regression analysis showed that the detection rate of carotid plaques in MS patients was higher than that in non-MS patients (71.4 vs 53.6%). There was no significant correlation between HP infection and carotid intima-media thickness change (95 CI: 1.102.04). The incidence of carotid plaque formation in MS with HP infection (73.8%) was higher than that in normal group (53.4%), simple MS group (68.2%) and simple HP infection group (53.7%). The incidence of carotid plaque formation in hyperuricemia group was higher than that in normal group (67.0 vs 54.60%). The positive rate of carotid plaque formation in hypertension group was higher than that in normal group (71.90 vs 44.80%). The positive rate of carotid plaque formation in hyperglycemia or / and diabetes group was higher than that in normal group (77.0 vs 52.90%), OR1.83 (95 CI: 1.31 卤2.57). There was no correlation between the components of other metabolic syndrome and carotid intima-media thickness. 4. After stratified analysis according to sex, there was no significant correlation between MS and CIMT in women with hyperuricemia, and there was no significant correlation between MS and CIMT in patients with HP infection. There was no significant correlation between HP infection with hyperglycemia and diabetes mellitus and CIMT in both males and females. There was no significant correlation between hyperglycemia and / or diabetes mellitus and carotid intima-media thickness in people aged 鈮，

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