急性冠状动脉综合征与现症幽门螺杆菌感染的相关性

Relationship Between Acute Coronary Syndrome and Present Helicobacter Pylori Infection

[目的]探讨现症幽门螺杆菌（Hp）感染与急性冠状动脉综合征（ACS）的相关性,并通过相关炎症因子的变化探讨其致病机理.[方法]对113例经冠状动脉造影及临床检查确诊为ACS的患者及52例因其他疾病入院经冠状动脉造影（CAG）排除冠心病（CHD）的患者,以^14C-尿素呼气试验阳性作为现症Hp感染诊断指标,同时检测高敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-1三种炎症因子及血清幽门螺杆菌抗体（Hp IgG）.[结果]ACS患者现症HP感染率（45.1%）显著高于非冠心病患者（19.2%）、三种炎症因子水平ACS组均明显高于非冠心病组（ P〈0.01）,现症HP感染者中有76.5%合并慢性Hp感染,通过多元回归分析,提示高敏C反应蛋白及Hp现症感染和慢性感染同时并存与ACS相关性最强.[结论]急性炎症反应可能是ACS发病的促发因素之一,而现症Hp感染可能通过激发急性炎症反应参与ACS的发生.

[Objective] To explore the relationship between present helicobacter pylori（Hp） infection and acute coronary syndrome（ACS）, and to investigate the mechanism by observing the changes of related inflammatory factors. [Methods] Totally 113 ACS patients diagnosed by coronary angiography and clinical examina- tion and 52 patients with other diseases which were excluded coronary heart diseases by coronary angiography were enrolled. The positive ^14C-urea breath test was used as diagnosis indicators of present Hp infection. Three inflammatory factors such as high sensitivity C-reactive protein（hsCRP）, tumor necrosis factor-α（TNF-α）, interleukin-1（IL-1） and serum helicobacter pylori antibody（ Hp IgG） were detected. [Results] In ACS patients, the rate of present helicobacter pylori infection（45.1%） was significantly higher than that of non-coronary heart disease group（19.2 %）, and the levels of three inflammatory cytokines were also significantly higher, and there was significant difference between two groups（ P 〈0.01）. About 76.5% present Hp infection patients were complicated with chronic Hp infection. Multiple regression analysis showed that hsCRP and the concomitance of present Hp infection and chronic Hp infection were strongly correlated with ACS. [Conclusion]Acute inflammatory response may be one of the factors which trigger the pathogenesis of ACS, and present Hp infection may play a role in the process of ACS by stimulating acute inflammatory response.