Helicobacter pylori seropositivity is associated with enhanced platelet activation in patients with intermittent claudication
Helicobacter pylori seropositivity is associated with enhanced platelet activation in patients with intermittent claudication
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DOI：
10.1016/j.jvs.2003.09.042
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发表时间：
2004-03-01
影响因子：
4.3
通讯作者：
Brittenden, J
中科院分区：
文献类型：
--
作者：
Cassar, K;Bachoo, P;Brittenden, J
目的：间歇性跛行患者因心血管和脑血管原因死亡的风险显著增加。幽门螺杆菌感染和血小板功能异常已被证明与动脉粥样硬化以及急性缺血事件有关。本研究的目的是评估第一次幽门螺杆菌血清学状态，血小板活化和内皮损伤的患者间歇性claudiation.Design的研究：一个前瞻性的观察性研究125例间歇性跛行适合血管成形术进行了在血管单位的阿伯丁皇家医院。主要结果指标为（1）使用ELISA试剂盒检测幽门螺杆菌免疫球蛋白G抗体的幽门螺杆菌血清学和（2）静息血小板P-选择素表达和纤维蛋白原结合的全血流式细胞术分析作为血小板活化的指标。结果以血小板百分比表示。使用ELISA测量血管性血友病因子水平作为内皮损伤的标志物。计算所有患者的Carstair剥夺评分。幽门螺杆菌血清学阳性62例（49.6%），阴性56例（44.8%），可疑7例（5.6%）。与血清阴性患者相比，幽门螺杆菌阳性患者的P-选择素表达中位数显著增加（0.815 vs 0.65; P = 0.039）。血清阳性患者的中位血小板纤维蛋白原结合率较高，但未达到统计学显著性（2.135 vs; 1.85%; P = 0.11）。两组间的von Wildebrand因子水平无差异（P = 0.51）。有两个groups.Conclusion之间的社会经济地位没有差异：间歇性跛行患者幽门螺杆菌阳性显示增强血小板活化，似乎不介导的内皮细胞损伤的手段。
Objective: Patients with intermittent claudication have a significantly increased risk of mortality from cardiovascular and cerebrovascular causes. Helicobacter pylori infection and abnormal platelet function have been shown to be associated with atherosclerosis as well as with acute ischemic events. The aim of this study was to assess for the first time the relation between H pylori serology status, platelet activation, and endothelial injury in patients with intermittent claudication.Design of study: A prospective observational study of 125 patients with intermittent claudication suitable for angioplasty was conducted at the Vascular Unit of the Aberdeen Royal Infirmary.Main outcome measures. Main outcome measures were (1) H pylori serology using ELISA kit for immunoglobulin G antibody to H pylori and (2) whole blood flow cytometric analysis of resting platelet P-selectin expression and fibrinogen binding as measures of platelet activation. Results are presented as platelet percentage. von Wildebrand factor levels were measured using ELISA as a marker of endothelial injury. Carstair deprivation scores were calculated for all patients.Results. H pylori serology was positive in 62 patients (49.6%), negative in 56 (44.8%) and equivocal in 7 (5.6%). Median P-selectin expression was significantly increased in H pylori-positive patients compared with seronegative patients (0.815 vs 0.65; P =.039). Median platelet fibrinogen binding was higher in seropositive patients, but this failed to reach statistical significance (2.135 vs; 1.85%; P =.11). There was no difference in von Wildebrand factor levels between the two groups (P =.51). There was no difference in socioeconomic status between the two groups.Conclusion: Patients with intermittent claudication who are H pylori positive show enhanced platelet activation that does not appear to be mediated by means of endothelial cell injury.