幽门螺杆菌感染与冠心病患者上消化道出血的相关性研究

Correlation between Helicobacter pylori infection and upper gastrointestinal bleeding of coronary heart disease patients

目的探讨并分析幽门螺杆菌(Hp)感染与冠心病(CHD)患者上消化道出血的相关性,以降低CHD患者上消化道出血的发生率。方法随机选择医院2013年1月-2014年12月诊治的CHD上消化道出血患者58例,设为观察组,选择同时期诊治的CHD未发生上消化道出血患者79例作为对照组,采用回顾调查法观察两组患者基本情况,采用14 C尿素呼气试验检测患者Hp阳性率;测定血液总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及C-反应蛋白(CRP)浓度。结果两组患者家族史、吸烟史、吸烟量、饮酒史、合并慢性病及体质量指数(BMI)等相关因素比较,差异无统计学意义,两组患者TG、TC、HDL和LDL结果比较,差异无统计学意义;观察组患者CRP为(57.13±2.27)mg/L,高于对照组的(31.45±2.41)mg/L,差异有统计学意义(P<0.05);观察组14 C尿素呼气试验阳性率为67.24%,对照组为6.33%,观察组明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论 CHD上消化道出血是由多因素综合所致,Hp感染是一个独立危险因素,存在一定的相关性,临床上治疗CHD应减少患者Hp感染,以改善患者预后。

OBJECTIVE To explore the correlation between the Helicobacter pylori infection and upper gastrointes‐tinal bleeding of the coronary heart disease （CHD） patients so as to reduce the incidence of upper gastrointestinal bleeding in the CHD patients .METHODS Totally 58 CHD patients with upper gastrointestinal bleeding who were treated in the hospital from Jan 2013 to Dec 2014 were assigned as the observation group ,meanwhile ,79 CHD pa‐tients without gastrointestinal bleeding were set as the control group .A retrospective survey was conducted to ob‐serve the basic data of the two groups of patients ,the positive rate of H .pylori was tested by using 14C urea breath test ,and the concentrations of the plasma total cholesterol （TC） ,triglyceride （TG） ,high density lipopro‐tein （HDL） cholesterol ,low density lipoprotein （LDL） cholesterol ,and C‐reactive protein （CRP） were deter‐mined .RESULTS As compared with the family history ,smoking history ,drinking history ,complication of chronic disease ,and body mass index （BMI） ,there was no significant difference between the two groups ;there was no significant difference in the concentration of TG ,TC ,HDL or LDL between the two groups ;the concentration of CRP of the observation group was （57 .13 ± 2 .27）mg/L ,significantly higher than （31 .45 ± 2 .41）mg/L of the control group（P〈0 .05）;the positive rate of the 14 C urea breast test of the observation group was 67 .24% ,sig‐nificantly higher than 6 .33% of the control group（P〈0 .05） .CONCLUSION The upper gastrointestinal bleeding of the CHD patients is under the joint effect of multiple factors ,the H .pylori infection is an independent risk factor and shows certain association .It is necessary for the hospital to reduce the incidence of H .pylori infection in the CHD patients so as to improve the prognosis of the patients .