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1型糖尿病患者根除幽门螺杆菌感染后脂质和止血模式的改善。

Improvement in lipid and haemostasis patterns after Helicobacter pylori infection eradication in type 1 diabetic patients.

作者信息

de Luis D A, Garcia Avello A, Lasuncion M A, Aller R, Martin de Argila C, Boixeda de Miquel D, de la Calle H

机构信息

Department of Endocrinology, Hospital Ramon y Cajal, Universidad de Alcala de Henares, Madrid, 28034, Spain.

出版信息

Clin Nutr. 1999 Aug;18(4):227-31. doi: 10.1016/s0261-5614(99)80074-0.

Abstract

Helicobacter pylori has been implicated in the cardiovascular risk of diabetic patients. The aim of our study was to investigate whether the Helicobacter pylori infection plays a role in the lipid and haemostasis patterns of type 1 diabetic patients. Twenty nine patients with type 1 diabetes mellitus and H. pylori infection were enrolled (Chlamydia pneumoniae negative). The H. pylori infection status was assessed by serology and urease breath test. In all patients levels of total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, lipoprotein (a) (Lpa) C reactive protein (CRP), fibrinogen, thrombin/antithrombin III complex (TAT), plasminogen activator inhibitor type 1(PAI-1), tissue plasminogen activator (t-PA) and von Willebrand antigen were measured. All patients were evaluated before and after H. pylori eradicating treatment with amoxicillin, clarithromycin and omeprazole. Twenty two patients were eradicated and seven remained infected. In H. pylori eradicated patients, HDL cholesterol increased (59.7+/-18.9 mg/dl vs 65.2+/-15. 9 mg/dl, P << 0.05), after treatment. After H. pylori eradication, the levels of CRP and TAT decreased (48+/-0.7 ng/l vs 3.3+/-0.4 ng/l;P << 0.05), (27.7+/-44.7 microg/ml vs 2.1+/-1.4 microg/ml, P << 0.05), respectively. The decrease in TAT was higher in the group of H. pylori (+) patients with higher levels of TAT (TAT >> 20 ng/ml, 92.8+/-41.6 ng/ml vs 1.9+/-2.0 ng/ml, P << 0.005; TAT 4Eth 20 ng/ml; 10.1+/-5.2 ng/ml vs 2.2+/-0.6 ng/ml, P << 0.05). These changes did not occur in patients without H. pylori eradication. Eradication of H. pylori infection in type 1 diabetic patients modifies some parameters of lipid and haemostasis patterns, (increase of HDL-cholesterol, reduction of Lpa and decrease of CRP and TAT) and so contributes to improvement of cardiovascular risk factors in these patients.

摘要

幽门螺杆菌与糖尿病患者的心血管风险有关。我们研究的目的是调查幽门螺杆菌感染是否在1型糖尿病患者的血脂和止血模式中起作用。招募了29例1型糖尿病合并幽门螺杆菌感染的患者(肺炎衣原体阴性)。通过血清学和尿素呼气试验评估幽门螺杆菌感染状态。检测所有患者的总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)(Lpa)、C反应蛋白(CRP)、纤维蛋白原、凝血酶/抗凝血酶III复合物(TAT)、纤溶酶原激活物抑制剂1型(PAI-1)、组织纤溶酶原激活物(t-PA)和血管性血友病因子抗原水平。所有患者在接受阿莫西林、克拉霉素和奥美拉唑根除幽门螺杆菌治疗前后均进行评估。22例患者根除成功,7例仍感染。在根除幽门螺杆菌的患者中,治疗后高密度脂蛋白胆固醇升高(59.7±18.9mg/dl对65.2±15.9mg/dl,P<<0.05)。根除幽门螺杆菌后,CRP和TAT水平分别降低(48±0.7ng/l对3.3±0.4ng/l;P<<0.05),(27.7±44.7μg/ml对2.1±1.4μg/ml,P<<0.05)。TAT水平较高的幽门螺杆菌(+)患者组中TAT的下降幅度更大(TAT>>20ng/ml,92.8±41.6ng/ml对1.9±2.0ng/ml,P<<0.005;TAT≤20ng/ml;10.1±5.2ng/ml对2.2±0.6ng/ml,P<<0.05)。未根除幽门螺杆菌的患者未出现这些变化。根除1型糖尿病患者的幽门螺杆菌感染可改变血脂和止血模式的一些参数(高密度脂蛋白胆固醇升高、Lpa降低、CRP和TAT降低),从而有助于改善这些患者的心血管危险因素。

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