The Relationship Between Helicobacter Pylori Infection And Carotid Atherosclerosis In The Elderly

Objective:To investigate the relationship between Helicobacter pylori（Hp）infection and carotid atherosclerosis（CAS）in the elderly,in order to provide an empirical basis for the prevention and treatment of cardiovascular and cerebrovascular diseases in the elderly.Methods:A total of 287 patients aged 60 years and over admitted to the First Affiliated Hospital of Guangxi Medical University,who underwent the¹³C-urea breath test(¹³C-UBT),carotid color and two-dimensional Doppler ultrasonogra-phy from October 2015 to January 2019,were retrospectively enrolled.Patients were divided into the Hp infection group（n=137）and the non-Hp infection group（n=150）.Common high-risk pathogenic factors,blood biochemical indicators,carotid intima-media thickness（CIMT）and detection rate of carotid plaque were compared between the two groups.Results:Common high-risk pathogenic factors including age,gender,hypertension,diabetes,obesity,smoking,alcohol consumption,dyslipidemia,and hyperuricemia showed no significant difference between the two groups（P>0.05）.The level of high density lipoprotein cholesterol（HDL-C）was lower in the Hp infection group than in the non-Hp infection group（Z=-2.538,P=0.011）.There was no difference in levels of white blood cells,neutrophils,total cholesterol（TC）,triglycerides（TG）,low density lipoprotein cholesterol（LDL-C）,homocysteine,fasting blood glucose,creatinine or uric acid between the two groups（P>0.05）.The detection rates of CIMT thickening in Hp infection group and non-Hp infection group were 65.0%and 48.7%,respectively.The detection rate of CIMT thickening in Hp infection group was higher than that in non-Hp infection group,the difference was statistically significant（х²=7.735,P=0.004）.The detection rate of carotid plaque in Hp infection group and non-Hp infection group was 76.6%and 64.7%,respectively.The detection rate of carotid plaque in Hp infection group was higher than that in non-Hp infection group,the difference was statistically significant（х²=4.926,P=0.018）.The detection rates of CIMT thickening and plaque in the Hp infection group and the non-Hp infection group were 56.2%and 32.7%,respectively.The detection rate of CIMT thickening and plaque in the infection group was higher than that in the non-Hp infection group,and the difference was statistically significant（х²=16.107,P<0.001）.The detection rate of CIMT thickening in the Hp mild infection group was 67.8%,58.3%in the Hp moderate infection group,66.7%in the Hp severe infection group,the difference was not statistically significant（х²=0.957,P=0.620）;The plaque detection rate in the Hp mild infection group was 74.6%,80.6%in the Hp moderate infection group,76.2%in the Hp severe infection group,the difference was not statistically significant（х²=0.453,P=0.797）.The detection rate of CIMT thickening and plaque in the mild Hp infection group was 61.0%,52.8%in the Hp moderate infection group,52.4%in the Hp severe infection group,the difference was not statistically significant（х²=0.976,P=0.614）.Further analysis indicated that there was no difference in the degree of CAS between different Hp infection levels（х²=4.459,P=0.615）.Conclusion:Hp infection may be related to decrease of serum HDL-C,thickening of carotid intima-media and carotid artery plaque formation.Hp infection may play a role in the occurrence and progression of carotid atherosclerosis through initiating abnormal lipid metabolism.The degree of Hp infection has no significant relationship with carotid intima-media thickening,carotid plaque formation rate and CAS degree.