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幽门螺旋杆菌感染与子痫前期的关系

余婷,  彭芸花

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文章导航 > 协和医学杂志  > 2020 >  11(5): 596-600
余婷, 彭芸花. 幽门螺旋杆菌感染与子痫前期的关系[J]. 协和医学杂志, 2020, 11(5): 596-600. doi: 10.3969/j.issn.1674-9081.2020.05.016
引用本文: 余婷, 彭芸花. 幽门螺旋杆菌感染与子痫前期的关系[J]. 协和医学杂志, 2020, 11(5): 596-600. doi: 10.3969/j.issn.1674-9081.2020.05.016
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Ting YU, Yun-hua PENG. Relationship between Helicobacter Pylori and Preeclampsia[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 596-600. doi: 10.3969/j.issn.1674-9081.2020.05.016
Citation: Ting YU, Yun-hua PENG. Relationship between Helicobacter Pylori and Preeclampsia[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 596-600. doi: 10.3969/j.issn.1674-9081.2020.05.016
shu

幽门螺旋杆菌感染与子痫前期的关系

doi: 10.3969/j.issn.1674-9081.2020.05.016
  • 1.

    兰州大学第一临床医学院，兰州 730000

  • 2.

    海南医学院第二附属医院妇产科，海口 750000

详细信息
    通讯作者:

    彭芸花  电话：0931-8356934，E-mail：2008pengyh@163.com

  • 中图分类号: R544.1+5; R573.1

Relationship between Helicobacter Pylori and Preeclampsia

  • 1.

    First Clinical Medical College of Lanzhou University, Lanzhou 730000, China

  • 2.

    Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Hainan Medical University, Haikou 750000, China

More Information

    摘要
  • 摘要: 幽门螺旋杆菌是最常见的消化道致病菌，参与急性胃肠炎、消化性溃疡、胃肠肿瘤等胃肠道疾病的发生发展, 与胃肠外疾病也有密切联系。研究发现，幽门螺旋杆菌感染与子痫前期存在明确的流行病学因果关系，特别是细胞毒素相关基因A(cytotoxin-associated gene A, cagA)阳性的幽门螺旋杆菌菌株诱导产生的抗cagA抗体可与滋养层细胞发生免疫反应导致滋养细胞浸润异常。此外，幽门螺旋杆菌感染引起的炎症反应、脂质代谢异常可造成血管内皮功能异常，导致子痫前期。本文将对幽门螺旋杆菌感染与子痫前期的关系作一综述。
    Abstract: Helicobacter pylori is one of the most common pathogenic bacteria of the digestive tract, which is involved in the etiology of acute gastroenteritis, peptic ulcer, gastrointestinal tumor and Parenteral diseases. The epidemiological relationship between Helicobacter pylori and preeclampsia has been confirmed currently. Even tighter association has been found between preeclampsia and infection of cytotoxin-associated gene A (cagA) positive strains of Helicobacter pylori. The anti-caga antibody induced by Helicobacter pylori can have an immune reaction with trophoblast cells, leading to abnormal trophoblast infiltration. In addition, the inflammation and abnormal lipid metabolism caused by Helicobacter pylori can cause abnormal vascular endothelial function, leading to the onset of preeclampsia and the generation of long-term complications. This article reviews the relationship between Helicobacter pylori and preeclampsia and the latest research progress.
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  • 表  1  幽门螺旋杆菌感染与子痫前期的相关研究

    第一作者(发表年份) 地区 研究类型 样本量(n) 结局
    Cardaropoli(2011)[8] 意大利 病例对照 Ca：62
    Co：49    		 与对照组(42.9%)比较，PE组HP感染比率(85.7%)更高(OR=9.22, 95% CI:2.83~30.04, P＜0.001)；抗cagA抗体阳性率升高(81.6%比22.4%, OR=17.66, 95% CI:5.25~59.49, P＜0.001)
    Ponzetto(2006)[10] 意大利 病例对照 Ca：47
    Co：47    		 PE患者HP血清阳性率(51.1%)高于正常孕妇(31.9%)(OR=2.668, 95% CI: 1.084~6.566, P=0.033)，cagA阳性率分别为80.9%和14.9%(OR=26.035, 95% CI:8.193~82.729, P＜0.001)；胎盘组织HP DNA均为阴性
    Ahmed(2020)[11] 苏丹 病例对照 Ca：93
    Co：93    		 PE妇女HP阳性率较正常孕妇高(86.0%比55.9%, P＜0.001)
    Simone(2017)[12] 意大利 病例对照 Ca：93
    Co：87    		 PE妇女HP阳性率较高(57.0%比33.3%, P＜0.001)；PE妇女中cagA血清阳性率也更高(45.2%比13.7%, P＜0.001)
    den Hollander(2016)[13] 荷兰 前瞻性队列 6348 HP阳性率为46%(2915/6348)，cagA阳性率为35%(1023/2915)，PE发生率为2.0%(129/6348)；HP感染与PE有关(OR=1.51, 95% CI:1.03~2.25)
    Elkhouly(2016)[14] 埃及 病例对照 Ca：50
    Co：50    		 合并宫内生长迟缓的PE组HP粪便抗原阳性率高于正常妊娠组(76%比32%, P＜0.0001)
    Mosbah(2016)[15] 埃及 病例对照 Ca：90
    Co：90    		 PE患者HP血清阳性率为54.4%(49/90)，高于对照组21.1%(19/90)(P=0.0001)
    Kuo(2014)[16] 台湾 前瞻性队列 346 HP感染率为30.3%(105/346)
    Cardaropoli(2015)[17] 意大利 前瞻性队列 2820 HP血清阳性率为28.5%(804/2820)，其中PE患者HP血清阳性率为28.1%(16/57)，非PE孕妇HP血清阳性率为28.5%(778/2763)(OR=0.978, 95% CI:0.546~1.753，P=0.941)
    ÜstÜn(2010)[18] 土耳其 病例对照 Ca：40
    Co：40    		 PE组HP抗体阳性率为35% (14/40)，对照组为12.5%(5/40)(P=0.034)；HP阳性者血清C反应蛋白和肿瘤坏死因子-α水平更高
    Aksoy(2010)[19] 土耳其 病例对照 Ca：53
    Co：30    		 PE组HP血清阳性率为81%(43/53)，正常对照组为60%(18/30)(OR=2.86, 95% CI: 1.05~7.82, P=0.036)；HP阳性组血清总胆固醇、低密度脂蛋白胆固醇水平及平均丙二醛浓度高于HP阴性组(P＜0.001)
    Pugliese(2008)[20] 意大利 病例对照 Ca：25
    Co：25    		 PE患者HP血清阳性率为84%(21/25)，正常孕妇为32%(8/25)(P＜0.001)；PE患者和正常孕妇血清抗cagA抗体阳性率分别为80%(20/25)和28%(7/25)(P＜0.001)；PE患者和正常孕妇白细胞介素-18水平无明显差异(P=0.23)
    Ca：病例组；Co：对照组；HP：幽门螺旋杆菌；PE：子痫前期；cagA：细胞毒素相关基因A
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    • 参考文献(34)
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  • 收稿日期:  2019-08-29
  • 刊出日期:  2020-09-30

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