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Correlation between Helicobacter pylori infection and disease condition and prognosis of stable chronic obstructive pulmonary disease

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Author:
No author available
Journal Title:
International Journal of Respiration
Issue:
2
DOI:
10.3760/cma.j.cn131368-20220825-00755
Key Word:
肺疾病,慢性阻塞性;幽门螺旋杆菌;炎症反应;核因子κB;预后;预测;Pulmonary disease, chronic obstructive;Helicobacter pylori;Inflammatory reaction;Nuclear factor-κB;Prognosis;Prediction

Abstract: Objective:To identify the correlation between Helicobacter pylori (H.pylori) infection and the condition and prognosis of stable chronic obstructive pulmonary disease (COPD).Methods:It was a retrospective cohort study involving 120 patients with stable COPD admitted in Liuzhou People′s Hospital who were non-randomly enrolled from January 2018 to September 2020.The radioactive carbon count was measured by 14C urea breath test for diagnosing H. pylori infection.Patients with the radioactive carbon count≥100 dpm/mmol were enrolled in H. pylori-positive group ( n=48), and those with the radioactive carbon count<100 dpm/mmol were enrolled in H. pylori-negative group ( n=72).Another 50 healthy volunteers age-matched with COPD patients were selected as control group.FEV 1/FVC (the forced expiratory volume in one second/forced vital capacity) and FEV 1%pred (a derived value of FEV 1%) were measured by a pulmonary function analyzer.The expression of nuclear factor-κB (NF-κB) mRNA in peripheral blood was detected by Real time-quantitative PCR (RT-qPCR) technology.The contents of TNF-α, IL-1β and ICAM-1 were detected by Enzyme-linked immunosorbent assay (ELISA).The acute exacerbation of COPD was followed up. Results:FEV 1%pred and FEV 1/FVC in H. pylori-positive group were (57.10±9.99)% and (51.69±11.45)%, which were significantly lower than those in control group and H. pylori-negative group (all P<0.05).The expression level of NF-κB mRNA and the contents of serum TNF-α, IL-1β, and ICAM-1 were 1.43±0.27, (29.67±6.05) μg/L, (6.75±1.24) μg/L, and (351.20±85.17) μg/L, respectively, which were significantly higher than those of control group and H. pylori-negative group (all P<0.05).In H. pylori-positive group, the radioactive carbon count was negatively correlated with FEV 1%pred ( r=-0.40), and FEV 1/FVC ( r=-0.33), but positively correlated with the expression level of NF-κB mRNA ( r=0.48), TNF-α ( r=0.48), IL-1β ( r=0.43), and ICAM-1 ( r=0.46)(all P<0.05).Kaplan-Meier survival curve analysis showed that the non-acute exacerbation rate and cumulative survival rate in H. pylori-positive group were significantly lower than those of H. pylori-negative group (both P<0.05).ROC curves visualized that the radioactive carbon count in 14C urea breath test had a predictive value for the acute exacerbation and survival of stable COPD patients, with the predicted area under the curve of 0.731 (95% CI: 0.628-0.833), and the sensitivity and specificity of 75.61% and 76.47%, respectively. Conclusions:H.pylori infection is significantly correlated with the decreasing pulmonary function, activation of inflammatory reaction, and increasing risk of acute exacerbation.Detection of the radioactive carbon count in 14C urea breath test has a predictive value for the prognosis of stable COPD.

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