急性心肌梗死患者幽门螺杆菌感染情况及其与上消化道出血的相关性

目的探讨急性心肌梗死(AMI)患者幽门螺杆菌(HP)感染情况及其与上消化道出血的相关性。方法通过13C-尿素呼气试验检测160例AMI患者(AMI组)及50例无明确冠状动脉粥样硬化性心脏病(简称冠心病)史患者(对照组)的HP感染率,观察AMI患者上消化道出血的发生率,并分析HP感染与上消化道出血的相关性。同时对160例AMI患者随访3个月,记录随访期间的主要心脏不良事件和上消化道出血事件。结果 AMI组90例(56%,90/160)患者检出HP阳性,明显高于对照组(42%,21/50)(P<0.05)。HP感染与AMI患者的年龄、性别、吸烟史、高血压病史、糖尿病史等冠心病危险因素无关(P>0.05),HP阳性组与HP阴性组比较,三酰甘油、高密度脂蛋白、低密度脂蛋白、超敏C-反应蛋白及纤维蛋白原等差异亦均无统计学意义(P>0.05)。5%(8/160)AMI患者在住院期间发生了上消化道出血。HP阳性与HP阴性AMI患者上消化道出血的发生率差异无统计学意义(P>0.05),随访期间的主要心脏不良事件和上消化道出血事件差异亦无统计学意义(P>0.05)。结论 HP感染与冠心病相关,但HP感染不能预测上消化道出血的风险,HP感染与AMI患者3个月的预后无明显相关性。

Helicobacter priori infection in patients with acute myocardial infarction and its correlation with up- per gastrointestinal bleeding

Objective To investigate Helicobacter priori （HP）infection in patients with acute myocardial infarction （AMI） and its interrelation with upper gastrointestinal bleeding. Methods The incidence of HP infection in 160 AMI patients （ AMI group） and 50 patients without definite coronary heart disease（ control group） was detected by 13 C-Urea breath test（ 13 C- UBT）, the prevalence of upper gastrointestinal bleeding was observed , and the interrelation between bleeding and HP infection was analyzed. The 160 patients were all followed up for three months and the major adverse cardial events（MACE） and upper gastrointestinal bleeding were recorded during the three months. Resulls In AMI group,90 patients（56% ,90/160） were ^13C- UBT HP positive, which was higher significantly than that of control group（42% ,21/50）（P 〈 0.05 ）. There was no interrela- tion between age, sex, smoking, hypertension, diabetes mellitus and HP infection in AMI patients （ P 〉 0.05 ）. The difference of triacylglycerol,bigh-density lipoprotein cholesterol, low-density tipoprotein cholesterol, high sensitivity c-response protein and fibrinogen between 13C-UBT HP positive and HP negative group was still not significant. Eight（5% ） of 160 AMI patients suf- fered from upper gastrointestinal bleeding during hospitalization（P 〉 0.05 ）. The prevalence of upper gastrointestinal bleeding was not significant statistically between HP positive and HP negative patients （ P 〉 0. 05 ）. The difference of the incidence of MACE and upper gastrointestinal bleeding during followed up period were aslo not significant statistically between HP positive and HP negative patients （ P 〉 0.05 ）. Conclusions There is some relation between HP infection and coronary heart diseases, but HP infection may not be the predictor of upper gastrointestinal bleeding. There is no relationship between HP infection and prognosis of three months later in patients with AMI.