幽门螺杆菌感染与非酒精性脂肪肝相关性研究-论文.pdf

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1、医学研究杂志2014年6月第43卷第6期·论善·幽门螺杆菌感染与非酒精性脂肪肝相关性研究彭朝阳盛晓燕丁海燕彭朝胜摘要目的探讨幽门螺杆菌(Helicobacterpylori，Hp)感染与非酒精性脂肪肝(nonalcoholicfattyliverdisease，NAFLD)的关系。方法选取笔者医院2009年2月～2013年l0月门诊及住院的受试者共250例分为两组，非酒精性脂肪肝组(A组)150例及健康对照组(B组)100例，通过”c一尿素呼气试验(”C—ureabreathtest，”C—UBT)

2、检测受试者”c同位素丰度，根据其结果计算超基准值(deltaoverbaseline，DOB)，判断其Hp感染情况。同时测定胰岛素、高敏C反应蛋白(high—sensitivityC—reac—tiveprotein，hs—CRP)、血脂系列，计算胰岛素抵抗指数(insulinresistanceindex，IRI)，并对相关数据进行对比分析。结果两组Hp总感染率为57．6％，NAFLD组Hp感染率为68．7％，明显高于对照组41％(P<0．01)；脂肪肝组DOB值，hs—CRP，IRI明显高于对照

3、组(P<0．O1)，其中DOB值与hs—CRP，IRI呈正相关；Logistic多元回归分析显示，DOB值、IRI、hs—CRP、甘油三酯(TG)与NAFLD密切相关。结论Hp感染是NAFLD的危险因子，其与胰岛素抵抗及hs—CRP密切相关。关键词幽门螺杆菌感染非酒精性脂肪肝胰岛素抵抗高敏C反应蛋白c一尿素呼气试验[中图分类号]R575[文献标识码]ARelationshipbetweenHelicobacterPyloriInfectionandNonalcoholicFattyLiverDise

4、ase．PengChaoyang，ShengXiaoyan，DingHaiyan，ela1．DepartmentofClinicalMedicine，Nanchang334hospital，Jiangxi330024，ChinaAbstract0bjectiveToinvestigatetherelationshipbetweenhelicobacterpyloriinfectionandnonalcoholicfattyliverdisease．MethodsThesurveywasconduct

5、edin250subjectsselectedfromourhospitalbetweenFebruary2009andOct2013．Basedonthediag—nosticcriteriaofNAFLD，thesubjectsweredividedintotwogroups：NAFLDgroup(n=150)，normalcontrolgroup(n=100)．Thelev—elof。Cabundancewasmeasuredby¨C—ureabreathtest．Thedeltaoverba

6、selinewascalcalated．TheHPinfectionwasdeterminedacocordingtotheDOB．Thelevelofseluminsulin，high—sensitivityc—reactiveprotein，bloodlipidseriesandtheinsulinresistanceindexwerealsodetermined．Thentherelateddatawereanalyzed．ResultsThetotalHpinfectionrateoftwo

7、groupswas57．6％．TheHpin—fectionrateofNAFLDgroupwas68．7％．Itwasobviouslyhigherthanthatofcontrolgroup(P<0．01)．IntheNAFLDgroup，theDOBvalue，hs—CRPandIR1weresignificantlyhigher(P<0．01)．Thelevelofhs—CRPandIR1werepositivelycorrelatedwithDOBvalue(r=0．422，0．363，a

8、UP<0．05)．LogisticregressionanalysisshowedthatthelevelofDOBvalue，IRI，hs—CRP，triglycerideswerecloselyassociatedwiththeNAFLD．ConclusionTheHpinfectionwasoneoftheriskfactorsforNAFLD．Itwascloselyassociatedwiththehs—CRPandinsulinresistance．Key