摘要
目的分析2型糖尿病(T2DM)患者发生幽门螺杆菌(Hp)再感染的相关危险因素,并提出相应的预防策略。方法选取2018年1月至2019年1月在上海市杨浦区市东医院接受治疗的经13C尿素呼气试验Hp阳性的110例T2DM患者为研究对象。所有患者均给予标准四联疗法抗Hp治疗2周,停药4周后复查检测阴性者98例;至1年后再次行Hp检测,根据检测结果将患者分为Hp再感染组23例和Hp阴性组75例。比较两组患者的性别、年龄、体质量指数等一般资料和空腹血糖(FBG)、空腹胰岛素(INS)、C肽、糖化血红蛋白(HbAlc)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、血尿酸(UA)、胰岛素抵抗指数(HOMA-IR)、糖尿病病程等疾病相关资料及吸烟史、饮酒史等生活习惯,应用二分类Logistic回归分析探讨各因素对HP再感染的影响。结果两组患者的年龄、男性比例、BMI、收缩压、舒张压、吸烟比例、饮酒比例比较差异均无统计学意义(P>0.05);再感染组和阴性组患者的病程[15(11,19)年vs 10(6,10)年]、INS[(12.26±2.34)mIU/L vs(9.78±1.32)mIU/L]、C肽[(1.97±0.22)ng/mL vs(1.73±0.29)ng/mL]、HbAlc[(8.42±0.96)%vs(7.12±0.56)%]、HOMA-IR(4.49±1.02 vs 3.09±0.65)比较,再感染组明显长于或高于阴性组,差异均具有统计学意义(P>0.05);两组患者FBG、TG、TC、LDL-C、HDL-C、UA比较差异均无统计学意义(P>0.05);二分类Logistic回归分析表明,糖尿病病程、HOMA-IR、HbAlc为Hp再感染的危险因素。结论糖尿病病程、HOMA-IR、HbAlc是T2DM患者发生Hp再感染的危险因素,在治疗中,应强化对血糖的控制,并维持适当运动量以降低胰岛素抵抗,进而减少HP再感染的发生。
Objective To explore and analyze the risk factors of Helicobacter pylori(Hp)reinfection in patients with type 2 diabetes(T2 DM),and to formulate corresponding prevention strategies.Methods A total of 110 patients with T2 DM who were treated at the Shanghai Yangpu District Shidong Hospital from January 2018 to January 2019 who had positive results in13 C-urea breath test were selected as the research objects.All patients were given standard quadruple therapy for anti-HP treatment for 2 weeks,and 98 patients were HP-negative four weeks after drug withdrawal.According to the13 C-urea breath test results after 1 year,the patients were divided into HP-reinfection group(23 cases)and HP-negative group(75 cases).The general data such as gender,age,body mass index,fasting blood glucose(FBG),fasting insulin(INS),C peptide,glycosylated hemoglobin(HbAlc),triglycerides(TG),total cholesterol(TC),low-density lipoprotein(LDL-C),high-density lipoprotein(HDL-C),blood uric acid(UA),insulin resistance index(HOMA-IR),diabetes course and other disease-related information,as well as smoking history,drinking history and other lifestyle habits were compared between the two groups.Binary logistic regression analysis was used to explore the impact of various factors on HP reinfection.Results There was no significant difference in age,male ratio,body mass index(BMI),systolic blood pressure,diastolic blood pressure,smoking ratio,and drinking ratio between the two groups(P>0.05);The reinfection group had significantly longer or higher course of disease,INS,C peptide,HbAlc,HOMA-IR than the HP-negative group(P<0.05):course of disease,15(11,19)years vs 10(6,10)years;INS,(12.26±2.34)mIU/L vs(9.78±1.32)mIU/L;C peptide,(1.97±0.22)ng/mL vs(1.73±0.29)ng/mL;HbAlc,(8.42±0.96)%vs(7.12±0.56)%;HOMA-IR,(4.49±1.02)vs(3.09±0.65).There was no statistically significant between the two groups in FBG,TG,TC,LDL-C,HDL-C,and UA(P>0.05).Binary logistic regression analysis showed that the course of diabetes,HOMA-IR,and HbAlc were risk factors for HP reinfecti
作者
虞晓燕
孟健
杨伟刚
郏琴
YU Xiao-yan;MENG Jian;YANG Wei-gang;JIA Qin(Department of Infectious Diseasethe Shanghai Yangpu District Shidong Hospital,Shanghai 200082,CHINA;Department of Endocrinologythe Shanghai Yangpu District Shidong Hospital,Shanghai 200082,CHINA;Respiratory Departmentthe Shanghai Yangpu District Shidong Hospital,Shanghai 200082,CHINA)
出处
《海南医学》
CAS
2021年第5期593-595,共3页
Hainan Medical Journal
关键词
2型糖尿病
幽门螺杆菌
再感染
危险因素
预防策略
Type 2 diabetes
Helicobacter pylori
Reinfection
Risk factors
Prevention strategies
