慢性肺源性心脏病病人幽门螺杆菌感染与炎症反应及白细胞总数的相关性分析

董世荣; 李进; 邢宁宁

doi:10.13898/j.cnki.issn.1000-2200.2023.10.017

慢性肺源性心脏病病人幽门螺杆菌感染与炎症反应及白细胞总数的相关性分析

Correlation of Helicobacter pylori infection with inflammatory response and leukocyte count in patients with chronic cor pulmonale

摘要

摘要:
目的探讨慢性肺源性心脏病(肺心病)病人幽门螺杆菌(Hp)感染与炎症反应及白细胞总数的相关性。
方法选取2018年2月至2020年7月134例肺心病病人作为病例组研究对象，根据Hp感染情况将其分为肺心病Hp阳性组(n=82)和肺心病Hp阴性组(n=52)。选取336例心肺功能正常者作为对照组，根据其Hp感染情况将其分为对照Hp阳性组(n=88)和对照Hp阴性组(n=248)。检测并比较各组研究对象的血气指标、白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平及外周血白细胞总数，应用多因素logistic回归进行分析其相关性。
结果病例组病人Hp感染阳性率为61.19%，明显高于对照组病人的26.19%(P < 0.01)。病例组病人的动脉血氧分压(PaO₂)、血氧饱和度(SaO₂)、酸碱度(pH)值均明显低于对照组，动脉血二氧化碳分压(PaCO₂)明显高于对照组，其中Hp阳性组病人的PaO₂、SaO₂、pH值均明显低于Hp阴性组，PaCO₂则明显高于Hp阴性组(P < 0.01)。病例组病人的血清IL-6、TNF-α、hs-CRP和IL-8水平均明显高于对照组，其中Hp阳性组中的血清炎症因子水平也均明显高于Hp阴性组(P < 0.01)。病例组病人的白细胞总数和中性粒细胞绝对值均明显高于对照组，且Hp阳性组也均明显高于Hp阴性组(P < 0.01)。多因素logistic回归分析发现，肺心病病人Hp感染与白细胞总数、中性粒细胞绝对值，血清IL-6、TNF-α、hs-CRP和IL-8水平，血气分析功能指标PaO₂、PaCO₂和SaO₂均有关(P < 0.05~P < 0.01)。
结论Hp感染与肺心病病人肺功能损害、全身炎症性反应和低氧血症等相关。

Abstract:
ObjectiveTo investigate the correlation between Helicobacter pylori (Hp) infection and inflammatory response and leukocyte count in patients with chronic cor pulmonale.
MethodsOne hundred and thirty-four in-patients with chronic cor pulmonale from February 2018 to July 2020 were selected as study subjects, who were divided into Hp-infected chronic cor pulmonale(n=82) and non-Hp-infected chronic cor pulmonale group(n=52) according to their Hp infection status.The 336 patients without chronic cor pulmonale were selected as the control group, who were divided into Hp-infected control group(n=88) and non-Hp-infected control group(n=248) according to their Hp infection or not.The blood gas indexes, interleukin(IL)-6, IL-8, tumor necrosis factor-α(TNF-α), hypersensitive C reactive protein(hs-CRP) levels and peripheral blood leukocytes were detected and compared, and the correlations were analyzed by multi-factor regression analysis.
Results61.19% patients were Hp positive in chronic cor pulmonale group, which was significantly higher than that of 26.19% in the control patients(P < 0.01).The arterial partial pressure of oxygen(PaO₂), saturation of oxygen(SaO₂) and acid-base(pH) values of patients in the chronic cor pulmonale group were significantly lower than those in the control group, and the arterial partial pressure of carbon dioxide(PaCO₂) was significantly higher than that in the control group (P < 0.01).The PaO₂, SaO₂ and pH values of patients in the Hp infection group were significantly lower than those in the non-Hp-infected group, while PaCO₂ was significantly higher than that in the non-Hp-infected group(P < 0.01).IL-6, TNF-α, hs-CRP and IL-8 levels were significantly higher in patients in the chronic cor pulmonale group than those in the control group, and the serum inflammatory factor levels were also significantly higher in the Hp-infected group than those in the non-Hp-infected group(P < 0.01).The leukocyte count and neutrophil fraction were significantly higher in the chronic cor pulmonale group than those in the control group, and both were also significantly higher in the Hp-infected group than those in the non-Hp-infected group(P < 0.01).Multivariate logistic regression analysis revealed that Hp infection in patients with chronic cor pulmonale was associated with total leukocyte and absolute neutrophil values, serum IL-6, TNF-α, hs-CRP and IL-8 levels, and functional indicators of blood gas analysis, PaO₂, PaCO₂ and SaO₂(P < 0.05 to P < 0.01).
ConclusionsHp infection is associated with the impairment of pulmonary function, systemic inflammatory response and hypoxemia in patients with chronic cor pulmonale.

HTML全文

参考文献(15)

施引文献

资源附件(0)