老年幽门螺杆菌感染患者空腹血糖和血脂变化研究

张排旗1，彭细娟2 ，王景杰1 ，姚立农2，郭学刚3

（第四军医大学唐都医院：1.消化科；2.重症监护室，陕西 西安，710038；3.第四军医大学西京医院消化科， 陕西 西安，710032）

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摘要：

目的 研究老年幽门螺杆菌感染患者空腹血糖（FBG）和血脂的变化并讨论其临床意义。方法 选择我院2015年1月至2016年12月于体检中心进行体检的，采用胃镜粘膜活检快速尿素酶试验法检测幽门螺杆菌（Hp）感染的284例老年人，其中 Hp阳性87例、Hp阴性197例。所有研究对象均测定FBG、甘油三脂（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和甘油三脂/高密度脂蛋白胆固醇（TG/HDL-C）等指标，并对Hp 阳性和阴性者的各指标进行比 较分析。结果 Hp阳性和Hp阴性者的年龄、血压和体质量指数（BMI）等一般资料比较，差异无统计学意义（P>0.05）。Hp阳性组的FBG平均水平为（5.68±1.22）mmol/L，高于Hp 阴性组的（4.56±0.86）mmol/L（P<0.05）；Hp阳性组的TG、TC 和TG/ HDL-C水平均高于Hp阴性组（P<0.05），两组HDL-C 和LDL-C水平比较，差异无统计学意义（P>0.05）；Hp 阳性组中TG、TC、LDL-C 检测结果超过正常值上限的人数所占比率均显著高于Hp阴性组（P<0.05）。结论 老年幽门螺杆菌感染可导致空腹血糖升高，同时伴有血脂改变。

关键词：老年患者；幽门螺杆菌；空腹血糖；血脂

中图分类号：R573.3文献标志码：A文章编号：2096-1413(2017)28-0001-03

Study on changes of fasting blood glucose and blood lipids in elderly patients with Helicobacter pylori infection
ZHANG Pai-qi 1, PENG Xi-juan 2, WANG Jing-jie 1, YAO Li-nong 2, GUO Xue-gang 3
(1. Department of Gastroenterology; 2. Intensive Care Unit, Tangdu Hospital of Fourth Military Medical University, Xi``an 710038; 3. Department of Gastroenterology, Xijing Hospital of Fourth Military Medical University, Xi``an 710032, China)

ABSTRACT: Objective To study the changes of fasting blood glucose (FBG) and blood lipids in elderly subjects with Helicobacter pylori (Hp) infection and discuss its clinical significance. Methods From January 2015 to December 2016 in our hospital, 284 cases of the elderly subjects who underwent physical examination were selected. Hp was detected by gastroscopy mucosa biopsy and rapid urease test, including 87 cases of Hp positive subjects and 197 cases of Hp negative subjects. Fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglyceride/high density lipoprotein cholesterol (TG/HDL-C) were measured in all subjects. These indicators were analyzed between Hp positive and negative subjects. Results There was no significant difference in age, blood pressure, body mass index (BMI) between the two groups of Hp positive and Hp negative (P>0.05). The level of FBG in the Hp positive group [(5.68 ±1.22) mmol/L ]was higher than that of Hp negative group [(4.56 ±0.86) mmol/L, P<0.05]. Compared with the Hp negative group, the levels of TG, TC and TG/HDL-C in the positive group were higher (P<0.05), but there was no significant difference in the levels of HDL-C between the two groups (P>0.05). The proportions of TG, TC, LDL-C levels exceeding the normal limit in the Hp positive group were higher than those of Hp negative group (P<0.05). Conclusion Hp infection of elderly patients can increase the level of FBG, along with changes in
blood lipids.
KEYWORDS: elderly patients; Helicobacter pylori; fasting blood glucose; blood lipid

参考文献:
[1] SUGANO K,TACK J,KUIPERS EJ,et al.Kyoto global consensus report on Helicobacter pylori gastritis[J].Gut,2015,64(9):1353-1367.
[2] SIMMONS RK,ALBERTI KG,GALE EA,et al.The metabolic syndrome: useful concept or clinical tool? Report of a WHO expert consultation[J].Diabetologia,2010,53(4):600-605.
[3] 何晋德,刘玉兰,叶辉,等.炎症性肠病患者幽门螺杆菌感染的血清学状况研究[J].中华消化杂志,2003,23(4):254-255.
[4] ZHANG M,ZHOU YZ,LI XY,et al.Seroepidemiology of helicobacter pylori infection in elderly people in the Beijing region, China[J].World J
Gastroenterol,2014,20(13):3635-3639.
[5] 李萌辉,张弛,梁晓峰,等.11 096 例体检者幽门螺杆菌感染现状分析[J].天津医药,2016,44(1):110-113.
[6] 张薇,吴李培,宣世海.幽门螺杆菌克拉霉素耐药的分子生物学检测研究进展[J].中华医院感染学杂志,2017,27(5):1197-1200.
[7] 赵巧云,谢勇.幽门螺杆菌外膜蛋白与黏附机制的研究进展[J].上海交通大学学报:医学版,2017,37(2):249-252.
[8] 汪楠,王垂杰,李玉锋.中药联合“四联疗法”治疗Hp 阳性慢性胃炎 疗效观察[J].中国中西医结合杂志,2017,37(4):406-409.
[9] GIANNINI C,SANTORO N,CAPRIO S,et al.The triglyceride -to -HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds[J].Diabetes Care,2011,34(8):1869-1874.
[10] ZHANG L,CHEN S,DENG A,et al.Association between lipid ratios and insulin resistance in a Chinese population[J].PLoS One,2015,10(1): e0116110.
[11] WANG C,ZHU W,WEI Y,et al.The predictive effects of early pregnancy lipid profiles and fasting glucose on the risk of gestational diabetes mellitus stratified by body mass index[J].J Diabetes Res,2016(2016): 3013567.
[12] KIM -DORNER SJ,DEUSTER PA,ZENO SA,et al.Should triglycerides and the triglycerides to high-density lipoprotein cholesterol ratio be used as surrogates for insulin resistance? [J].Metabolism,2010,59 (2): 299-304.
[13] 陈涛,沈丽丽,吴长明,等.幽门螺杆菌感染对肠易激综合征及分型 的影响[J].中华医院感染学杂志,2017,27(14):3212-3214,3218.
[14] 刘文忠,谢勇,陆红,等.第五次全国幽门螺杆菌感染处理共识报告 [J].中国实用内科杂志,2017,37(6):509-524.
[15] KANG HT,YOON JH,KIM JY,et al.The association between the ratio of triglyceride to HDL-C and insulin resistance according to waist circumference in a rural Korean population[J].Nutr Metab Cardiovasc Dis,2012,22(12):1054-1060.
[16] RIDAURA VK,FAITH JJ,REY FE,et al.Gut microbiota from twins discordant for obesity modulate metabolism in mice[J].Science,2013,341 (6150):1241214.