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目的:探讨幽门螺杆菌(Hp)根除前后细胞毒素相关基因A阳性(CagA+)对冠状动脉粥样硬化性心脏病(冠心病)患者血管内皮功能的影响。方法:选择Hp+CagA+冠心病患者57例为根除治疗组,同期住院的57例Hp-CagA-冠心病患者为对照组。在常规治疗的基础上,根除治疗组接受根除Hp治疗,对照组接受安慰剂治疗,研究期为6个月。两组研究对象在实验前后接受血脂、外周血循环内皮微颗粒(cEMP)水平及肱动脉对反应性充血的内皮依赖血管扩张反应(FMD)检测。结果:治疗后根除治疗组患者的血浆总胆固醇、cEMP水平比治疗前明显降低,FMD明显升高(P均<0.05)。治疗前根除治疗组总胆固醇高于对照组(P<0.01),治疗后两组总胆固醇比较差异无统计学意义(P>0.05)。结论:根除Hp+CagA+,可改善合并Hp+CagA+感染冠心病患者的血管内皮功能。
Objective: To investigate the effect of CagA + on the endothelial function of patients with coronary atherosclerotic heart disease (CHD) before and after the eradication of Helicobacter pylori (Hp). Methods: Fifty-seven patients with Hp + CagA + coronary heart disease were selected as eradication group and 57 Hp-CagA-CHD patients as control group. On the basis of routine treatment, the eradication group received eradication of Hp and the control group received placebo. The study period was 6 months. The two groups were tested for serum lipids, cEMP and brachial artery endothelium-dependent vasodilation (FMD) before and after the experiment. Results: After treatment, the levels of plasma total cholesterol and cEMP in patients with eradication therapy were significantly lower than those before treatment and FMD was significantly increased (all P <0.05). Before treatment, total cholesterol in the treatment group was significantly higher than that in the control group (P <0.01). There was no significant difference in total cholesterol between the two groups after treatment (P> 0.05). Conclusion: The eradication of Hp + CagA + can improve the vascular endothelial function in patients with CHD complicated with Hp + CagA + infection.