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目的分析Cag A阳性幽门螺杆菌(Hp)感染、同型半胱氨酸(Hcy)水平、糖尿病颈动脉粥样硬化之间的关系。方法选择行颈动脉超声检查的初次诊断糖尿病患者100例,根据有无颈动脉斑块分为斑块组和对照组各50例,行Hp抗体及抗体分型、Hcy及血脂检测。结果斑块组Hp-Ig G、Cag A-Ig G抗体检出率、血清Hcy水平高于对照组,差异有统计学意义(P<0.05);2组血脂水平比较差异无统计学意义(P>0.05)。Hp-Ig G+、Cag A-Ig G+患者血清Hcy水平均高于Cag A-Ig G-和Hp-Ig G-患者,差异有统计学意义(P<0.05);Cag A-Ig G-患者与Hp-Ig G-患者血清Hcy水平比较差异无统计学意义(P>0.05)。不同Hp感染类型血脂水平比较差异无统计学意义(P>0.05)。糖尿病患者斑块的发生与Hp感染类型相关(P<0.05);Hcy水平与糖尿病患者斑块的发生无明显相关性(P>0.05)。结论Hp-Cag A+菌株感染可能引起糖尿病患者血清Hcy水平增高,增加颈动脉粥样硬化斑块的发生风险。
Objective To analyze the relationship between Cag A positive Helicobacter pylori (Hp) infection, homocysteine (Hcy) and carotid atherosclerosis in diabetic patients. Methods One hundred patients with primary diagnosis of diabetes mellitus who underwent carotid ultrasonography were divided into plaque group and control group according to the presence or absence of carotid artery plaque in 50 cases. Hp antibody and antibody typing, Hcy and serum lipids were detected. Results The detection rates of Hp-Ig G and Cag A-Ig G antibody in plaque group were significantly higher than those in control group (P <0.05). There was no significant difference in serum lipid levels between the two groups (P > 0.05). The serum Hcy levels of Hp-Ig G + and Cag A-Ig G + patients were significantly higher than those of Cag A-Ig G- and Hp-Ig G- patients (P <0.05); Cag A-Ig G- Hp-Ig G-serum Hcy levels were no significant difference (P> 0.05). There was no significant difference in blood lipid levels between different Hp infection types (P> 0.05). The incidence of plaque in diabetic patients was related to the type of Hp infection (P <0.05). There was no significant correlation between the level of Hcy and the occurrence of plaque in diabetic patients (P> 0.05). Conclusion The infection of Hp-Cag A + strain may increase the serum Hcy level in diabetic patients and increase the risk of carotid atherosclerosis plaque.