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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

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
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

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
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

More Information
  • 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。
    利益冲突  无
  • 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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  • 收稿日期:  2019-08-29
  • 刊出日期:  2020-09-30

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