CAJ | 학술논문

探讨不同毒力菌株的幽门螺杆菌(Helicobacter pylori,Hp)感染对2型糖尿病(T2DM)患者胰岛素抵抗和血糖的影响.选择2012年1月至2013年3月住院的168例T2DM患者,男88例,女80例,病程(5.3±2.2)年,年龄(56±4)岁.采集胃肠道症状,并分别测定胰岛素抵抗指数(HOMA-IR)和糖化血红蛋白(HbA1c)、血脂、肝、肾功能等.应用Ho蛋白芯片检测Ho并进行毒力分型,将患者分为HoⅠ型组、Ⅱ型组和阴性组.各组患者继续降糖治疗的同时,对Ⅰ型组行Ho根除治疗,6个月后再次复查各项指标进行对比.多个样本均数两两比较采用方差分析.结果显示治疗前Ⅰ型组、Ⅱ型组和阴性组患者消化道症状阳性率分别为67.9％、28.9％和11.4％;HbA1c分别是(9.1±0.9)％、(8.2±0.8)％和(7.8±0.8)％;HOMA-IR分别为4.6±1.4、3.9±1.2和3.2±0.9.治疗后,Ⅰ型组消化道症状明显改善,3组的HbA1c分别下降为(7.3±0.8)％、(7.1±0.9)％和(6.9±0.6)％;HOMA-IR分别下降为3.9±1.3、3.4±1.1和3.1±0.8.Ⅰ型组HbA1c、HOMA-IR下降幅度最大,差异较治疗前有统计学意义(均P＜0.05).表明Hp感染尤其是毒力较强的Ⅰ型Hp感染患者胰岛素抵抗加重,血糖不易控制,应尽快根除治疗.
탐토불동독력균주적유문라간균(Helicobacter pylori,Hp)감염대2형당뇨병(T2DM)환자이도소저항화혈당적영향.선택2012년1월지2013년3월주원적168례T2DM환자,남88례,녀80례,병정(5.3±2.2)년,년령(56±4)세.채집위장도증상,병분별측정이도소저항지수(HOMA-IR)화당화혈홍단백(HbA1c)、혈지、간、신공능등.응용Ho단백심편검측Ho병진행독력분형,장환자분위HoⅠ형조、Ⅱ형조화음성조.각조환자계속강당치료적동시,대Ⅰ형조행Ho근제치료,6개월후재차복사각항지표진행대비.다개양본균수량량비교채용방차분석.결과현시치료전Ⅰ형조、Ⅱ형조화음성조환자소화도증상양성솔분별위67.9％、28.9％화11.4％;HbA1c분별시(9.1±0.9)％、(8.2±0.8)％화(7.8±0.8)％;HOMA-IR분별위4.6±1.4、3.9±1.2화3.2±0.9.치료후,Ⅰ형조소화도증상명현개선,3조적HbA1c분별하강위(7.3±0.8)％、(7.1±0.9)％화(6.9±0.6)％;HOMA-IR분별하강위3.9±1.3、3.4±1.1화3.1±0.8.Ⅰ형조HbA1c、HOMA-IR하강폭도최대,차이교치료전유통계학의의(균P＜0.05).표명Hp감염우기시독력교강적Ⅰ형Hp감염환자이도소저항가중,혈당불역공제,응진쾌근제치료.
To investigate the impact of different virulent strains of Helicobacterpylori (Hp) infection on the insulin resistance and glucose level in the type 2 diabetes mellitus (T2DM) patients.A total of 168 T2DM inpatients were recruited and gastrointestinal symptoms were collected from January 2012 to March 2013.Blood glucose,insulin levers,glycated hemoglobin A1c (HbA1c),blood lipids,liver function and kidney function were tested and IR indexs (HOMA-IR) were calculated for all patients.Based on the Hp protein microarray chip test,the patients were divided into type Ⅰ group,type Ⅱ group and negative group.Patients in each group continued hypoglycemic therapy while Hp eradication therapy were executed in type Ⅰ group.All indexs were rechecked 6 months later.Multiple sample mean pairwise comparisons using analysis of variance.Results showed before treatment,the cases of the type Ⅰ group,type Ⅱ group and negative group were 53,45 and 70,respectively.There had no statistical difference of the blood lipids,liver function,kidney function in the 3 groups,and the positive rate of gastrointestinal symptoms was 67.9％,28.9％ and 11.4％,respectively; HbA1c were (9.1 ± 0.9)％,(8.2 ± 0.8)％ and (7.8 ± 0.8)％,respectively; HOMA-IR were 4.6 ± 1.4,3.9 ± 1.2 and 3.2 ± 0.9,respectively.After eradication therapy for 6 months,gastrointestinal symptoms of type Ⅰ group decreased significantly.The HbA1c in the type Ⅰ group,type Ⅱ group and negative group decreased to (7.3 ± 0.8)％,(7.1 ± 0.9)％ and (6.9 ± 0.6)％,respectively; while the HOMA-IR in 3 groups decreased to 3.9± 1.3,3.4± 1.1 and 3.1 ±0.8,respectively.There was largest decline in HbA 1 c,HOMA-IR in type Ⅰ group.Compared with before treatment,the difference was statistically significant(both P＜0.05).We found that insulin resistance was increased in patients with infected Hp infection,especially with virulent type Ⅰ Hp infection,and which caused poor glycemic control.Treatment should be eradicated as soon as possible.