本文選題：代謝綜合征 + 幽門螺桿菌��； 參考：《山東大學(xué)》2017年碩士論文

【摘要】：研究目的探討代謝綜合征(MS)、幽門螺桿菌(Hp)感染與頸動脈內(nèi)膜-中層厚度(CIMT)的關(guān)系,進(jìn)一步分析MS的各組分、Hp感染的交互作用與CIMT的關(guān)系。探尋頸動脈粥樣硬化(CAS)的危險因素,進(jìn)而為心腦血管疾病的防治提供理論線索。研究方法選取2015年度在山東大學(xué)齊魯醫(yī)院查體中心體檢人員,通過內(nèi)科問診、生化檢查、C-13呼氣試驗以及頸動脈彩超等方式收集體檢人員的Hp感染、CIMT、空腹血糖、血脂、血壓等相關(guān)信息。采用STATA 13.0軟件對收集的數(shù)據(jù)進(jìn)行分析。應(yīng)用有序多分類Logistic回歸分析MS及其各組分、Hp感染及其交互作用與頸動脈內(nèi)膜-中層厚度的相關(guān)性。研究結(jié)果1.共納入符合條件的調(diào)查研究對象2279例,其中男性1439例,女性840例,年齡在20-80歲之間。男性頸動脈斑塊形成的檢出率均高于女性(60.9%VS46.4%)。各年齡組間CIMT差異具有統(tǒng)計學(xué)意義(P0.05)。2.1ogistic回歸分析結(jié)果顯示,MS患者的頸動脈斑塊的檢出率高于非MS患者(71.4%VS53.6%),OR=1.50(95%CI:1.10～2.04)。Hp感染與頸動脈內(nèi)膜-中層厚度變化的相關(guān)性無統(tǒng)計學(xué)意義OR=1.04(95%CI:0.87-1.25)。MS合并Hp感染患者的頸動脈斑塊形成的發(fā)生率(73.8%)高于正常組(53.4%)、單純MS 組(68.2%)以及單純Hp感染組(53.7%),OR=1.74(95%CI:1.14～2.67)。3.高尿酸血癥組頸動脈斑塊形成的發(fā)生率高于正常組(67.0%VS 54.60%),OR=1.69(95%CI:1.19～2.3)。高血壓組頸動脈斑塊形成的檢出率高于正常組(71.90%VS44.80%),OR=1.78(95%CI:1.46～2.18)。高血糖或(和)糖尿病組的頸動脈斑塊形成的檢出率高于正常組(77.0%VS 52.90%)OR=1.83(95%CI:1.31～2.57)。其它代謝綜合征的組分與頸動脈內(nèi)膜-中層厚度變化無相關(guān)性。4.根據(jù)性別進(jìn)行分層分析后,女性人群中高尿酸血癥、MS與CIMT的相關(guān)性無統(tǒng)計學(xué)意義,且Hp感染合并MS與CIMT的相關(guān)性也無統(tǒng)計學(xué)意義。無論男性還是女性,Hp感染合并高血糖或(和)糖尿病與CIMT的相關(guān)性均無統(tǒng)計學(xué)意義。根據(jù)年齡分層后,對于≤45歲和≥60歲的人群而言,高血糖或(和)糖尿病與頸動脈內(nèi)膜-中層厚度變化的相關(guān)性無統(tǒng)計學(xué)意義。研究結(jié)論1.MS可能是CAS的危險因素,Hp感染與CAS的發(fā)生沒有統(tǒng)計學(xué)相關(guān)性,當(dāng)MS合并Hp感染時,CAS檢出率增高。2.高尿酸血癥、高血壓可能是CAS的危險因素,且合并Hp感染對CIMT變化具有協(xié)同作用。高血壓以及高尿酸血癥患者應(yīng)尤其注意CAS的預(yù)防。3.高血糖或(和)糖尿病與CIMT密切相關(guān),BMI、TG、HDL-C可能不是CAS危險因素。
[Abstract]:Objective to investigate the relationship between metabolic syndrome (MS), Helicobacter pylori (HP) infection and carotid intima-media thickness (CIMT). To explore the risk factors of carotid atherosclerosis (CAS) and provide theoretical clues for the prevention and treatment of cardiovascular and cerebrovascular diseases. Methods Medical examiners from Qilu Hospital of Shandong University in 2015 were selected to collect HP infection with CIMT, fasting blood glucose and blood lipids by means of internal examination, biochemical examination and C-13 breath test. Blood pressure and other related information. The collected data were analyzed by STATA 13.0 software. The relationship between carotid intima-media thickness (IMT) and MS infection and its interaction with MS and its components were analyzed by logistic regression analysis. Results 1. A total of 2279 eligible subjects were included, including 1439 males and 840 females aged 20 to 80 years. The positive rate of carotid plaque formation in male was higher than that in female (60.9 vs 46.4%). The CIMT difference among different age groups was statistically significant (P0.05) .2.1 logistic regression analysis showed that the detection rate of carotid plaques in MS patients was higher than that in non-MS patients (71.4 vs 53.6%). There was no significant correlation between HP infection and carotid intima-media thickness change (95 CI: 1.102.04). The incidence of carotid plaque formation in MS with HP infection (73.8%) was higher than that in normal group (53.4%), simple MS group (68.2%) and simple HP infection group (53.7%). The incidence of carotid plaque formation in hyperuricemia group was higher than that in normal group (67.0 vs 54.60%). The positive rate of carotid plaque formation in hypertension group was higher than that in normal group (71.90 vs 44.80%). The positive rate of carotid plaque formation in hyperglycemia or / and diabetes group was higher than that in normal group (77.0 vs 52.90%), OR1.83 (95 CI: 1.31 鹵2.57). There was no correlation between the components of other metabolic syndrome and carotid intima-media thickness. 4. After stratified analysis according to sex, there was no significant correlation between MS and CIMT in women with hyperuricemia, and there was no significant correlation between MS and CIMT in patients with HP infection. There was no significant correlation between HP infection with hyperglycemia and diabetes mellitus and CIMT in both males and females. There was no significant correlation between hyperglycemia and / or diabetes mellitus and carotid intima-media thickness in people aged 鈮，

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