CAJ | 학술논문

目的：探讨幽门螺杆菌（HP）感染与颈动脉粥样硬化患者颈动脉内中膜厚度及斑块稳定性的关系和彩色多普勒超声诊断颈动脉粥样硬化的价值。方法选取2012年3月至2013年1月脑梗死患者206例为研究对象，采用彩色多普勒超声测定颈总动脉（CCA）、颈动脉分叉处（CB）及颈内动脉起始段（ CCI）内中膜厚度（ IMT）。观察颈动脉形态、斑块的有无及斑块的回声，并根据14 C 尿素呼气试验结果将所有受试者分为 HP 感染组和 HP 非感染组。分析幽门螺杆菌感染与颈动脉粥样硬化患者颈动脉内中膜厚度及斑块稳定性的关系。结果 HP 感染组的颈动脉硬化发生率为85.37%，明显高于 HP 非感染组73.49%，差异具有统计学意义（ P ﹤0.05）。颈动脉硬化患者 HP 感染组 CCA - IMT（1.05±0.19）mm、CB - IMT（1.08±0.21）mm 及 CCI - IMT（0.57±0.17）mm 显著高于 HP 非感染组（0.91±0.21）mm、（0.96±0.23）mm、（0.46±0.16）mm，差异均有统计学意义（ P ﹤0.01）；且颈动脉硬化患者 HP感染组不稳定斑块的发生率高于 HP 非感染组（ P ﹤0.05）。结论幽门螺杆菌感染可能通过增加颈动脉内中膜厚度和颈动脉粥样斑块的不稳定性从而促使脑梗死风险增加；颈动脉彩色多普勒超声可准确评估颈动脉内中膜的厚度及斑块的回声，为幽门螺杆菌感染者心脑血管病变的早期预防和治疗提供客观依据。
목적：탐토유문라간균（HP）감염여경동맥죽양경화환자경동맥내중막후도급반괴은정성적관계화채색다보륵초성진단경동맥죽양경화적개치。방법선취2012년3월지2013년1월뇌경사환자206례위연구대상，채용채색다보륵초성측정경총동맥（CCA）、경동맥분차처（CB）급경내동맥기시단（ CCI）내중막후도（ IMT）。관찰경동맥형태、반괴적유무급반괴적회성，병근거14 C 뇨소호기시험결과장소유수시자분위 HP 감염조화 HP 비감염조。분석유문라간균감염여경동맥죽양경화환자경동맥내중막후도급반괴은정성적관계。결과 HP 감염조적경동맥경화발생솔위85.37%，명현고우 HP 비감염조73.49%，차이구유통계학의의（ P ﹤0.05）。경동맥경화환자 HP 감염조 CCA - IMT（1.05±0.19）mm、CB - IMT（1.08±0.21）mm 급 CCI - IMT（0.57±0.17）mm 현저고우 HP 비감염조（0.91±0.21）mm、（0.96±0.23）mm、（0.46±0.16）mm，차이균유통계학의의（ P ﹤0.01）；차경동맥경화환자 HP감염조불은정반괴적발생솔고우 HP 비감염조（ P ﹤0.05）。결론유문라간균감염가능통과증가경동맥내중막후도화경동맥죽양반괴적불은정성종이촉사뇌경사풍험증가；경동맥채색다보륵초성가준학평고경동맥내중막적후도급반괴적회성，위유문라간균감염자심뇌혈관병변적조기예방화치료제공객관의거。
Objective To investigate the relationship between Helicobacter pylori(HP)infection and carotid artery intima - media thick-ness(IMT)and plaque stability of patients with carotid atherosclerosis. To evaluate the value of color Doppler ultrasound on carotid atherosclerosis detection. Methods All the 206 cerebral infarction inpatients were selected as research objects from March 2012 to January 2013. All patients are divided into HP positive group and HP negative group according to the results of their 14 C urea breath test. Furthermore,using Colour Doppler ultrasound measurements of common carotid artery( CCA),the bifurcation of carotid arteries( CB),intemal carotid arteries( CCI),intima -media thickness(IMT),and observed the morphology of the carotid artery. The existence of plaque and the echo strength were also investigated.We analyzed the correlation between HP infection and carotid IMT of patients with carotid atherosclerosis and the correlation between HP infection and the stability of carotid atherosclerosis plaque of patients with carotid atherosclerosis. Results HP positive group showed a higher carotid ather-osclerosis rate(85. 37% )than HP negative group(73. 49% ). This differences has statistical significance( P ﹤ 0. 05). In Patients with carotid atherosclerosis the CCA - IMT(1. 05 ± 0. 19)mm,CB - IMT(1. 08 ± 0. 21)mm and CCI - IMT(0. 57 ± 0. 17)mm of HP positive group is thicker than HP negative group(0. 91 ± 0. 21)mm、(0. 96 ± 0. 23)mm、(0. 46 ± 0. 16)mm. And the difference also has statistical significance( P ﹤ 0. 01). And the occurrence rate of unstable plague of patients with carotid atherosclerosis in HP positive group is higher than that of HP negative group( P ﹤ 0. 05). Conclusion Helicobacter pylori infection can probably increase the risk of cerebral infarction through increased carotid inti-ma - media thickness and carotid atherosclerotic plaque instability. Color Doppler ultrasound can accurately assess intima - media thickness of ca-rotid and echo strength of the plaque and provide an objective basis for early cardiovascular disease prevention and treatment of HP infection.