外周血白细胞总数及分类与幽门螺杆菌感染之间的关系研究

Relationship between the total white blood cells and the classification and helicobacter pylori infection

摘要:

目的：本研究通过分析幽门螺杆菌（Helicobacter pylori，Hp）感染与白细胞总数及分类之间的关系，以期探讨Hp参与炎症的途经。方法：对7 665例研究对象行13C尿素呼气试验测试；根据测试结果将研究对象分为13C阳性组（n=2 737）和13C阴性组（n=4 928），检测两组研究对象的血常规。运用卡方检验、方差分析等比较组间差异、运用限制性立方样条logistic回归分析年龄与13C阳性的非线性关系，运用多因素logistic回归分析13C阳性与白细胞总数及分类之间的关系。结果：与13C阴性组相比，13C阳性组的白细胞总数、中性粒细胞绝对值、淋巴细胞绝对值和单核细胞绝对值升高有统计学意义（P<0.05），且当4≤13C尿素呼气试验超过基准δ值（delta over baseline，DOB值）＜20时最高。年龄对13C阳性率的影响有统计学意义（P＝0.00０），女性在40~50岁达到高峰，男性在60岁左右达到高峰，但2组间的性别比较无统计学差异（P>0.05）。年龄也是13C阳性的危险因素（OR=1.012，95%CI=1.008~1.017）。结论：Hp感染可能与白细胞总数、中性粒细胞绝对值、淋巴细胞绝对值和单核细胞绝对值升高相关，不排除Hp通过激活中性粒细胞、淋巴细胞和单核细胞来参与炎症反应。另外，Hp感染与性别无关，与年龄之间呈抛物线关系。

Abstract:

Objective：to explore the way of Hp involvement in inflammation by analyzing the relationship between Hp infection and total white blood cell count and classification. Methods：Totally 7 665 patients were randomly selected from the health examination in 2016. All the subjects were tested by 13C urea expiratory test. According to the test results，the subjects were divided into 13C positive group（n=2 737） and 13C negative group（n=4 928），and the blood routine of all included subjects was also detected to explore the ap－plication of restricted cubic spline（RCS） in nonlinear regression. Restricted cubic spline was used to analyze the nonlinear relation－ship between age and 13C positive，chi-square test and analysis of variance were used to analyze differences of total white blood cell count and classification among groups. Results：Compared with those of subjects in the 13C negative group，the total white blood cells，the absolute value of neutrophils，the absolute value of lymphocytes and the absolute value of monocytes（P<0.05） were signifi－cantly higher in the 13C positive group. When delta over baseline（DOB） value was between 4 to 20，the age had significant effects on 13C positive（P=0.000），in which the women reached a peak at the age of 40 to 50，and men in their 60 years，but gender comparison between the two groups has no statistical significance（P>0.05）. Further analysis found that age was a risk factor for Hp infection（OR=1.012，95%CI=1.008 to 1.017）. Conclusion：Hp may participate in inflammatory response by activating neutrophils，lymphocytes and monocytes. Hp infection is not related to gender，and it has a parabolic relationship with age，and most importantly.