幽门螺杆菌感染及其毒力与急性心肌梗死、血浆纤维蛋白原及血栓素B_2的关系

The relationship among helicobacter pylori infection、virulence of Hp and acute myocardial infarction,fibrinogen,thromboxane B_2

目的 探讨幽门螺杆菌 (Hp)感染及其不同毒力与心肌梗死的关系。 方法 测定 5 1例急性心肌梗死 (AMI组 )和 42例陈旧性心肌梗死 (OMI组 )患者及 3 1例冠脉造影正常者 (对照组 )的Hp特异性抗体 (HpIgG、HpIgM )及其细胞毒素相关蛋白特异性抗体浓度 ,并同步观察血浆纤维蛋白原 (Fg)、血栓素B2 (TXB2 )变化及其与Hp感染的相关性。结果 AMI组HpIgG、HpIgM阳性率及平均浓度 (或OD值 )明显高于对照组 (P <0 .0 5 ) ;校正冠心病危险因素前、后 ,HpIgG阳性与AMI均具有相关关系。AMI组Fg、TXB2 明显高于对照组、OMI组。AMI组中Hp阳性者Fg、TXB2 明显高于Hp阴性者 (P <0 .0 5 )和OMI组中Hp阳性者 (P <0 .0 0 1) ;调整冠心病的危险因素前、后 ,IgG与Fg均呈正相关 (P <0 .0 5 )。 结论 Hp感染与AMI、Fg、TXB2 之间存在明显的相关性 。

Objective To investigate the relations among Helicobacter pylori(Hp) infection, virulence of Hp and acute myocardial infarction.Methods the concentration of Hp specific IgG ?IgM antibody and cytotoxin associated gene A(CagA) antigen were measured in 51 patients with acute myocardial infarction(AMI group),42 patients with old myocardial infarction (OMI group) and 31 normal controls (NC group). Simultaneously, the changes and relationships between fibrinogen(Fg),thromboxane B 2(TXB 2) and Hp infection were determined in the three groups.Results 76.47% of the AMI group were seropositive for Hp, and the average concentration (O.D.) of IgG(IgM) antibody to Hp was significantly higher than that of the NC group( P <0.05). CagA seropositive and average concentration of CagA Hp IgG were not significantly different in the three groups ( P <0.05). The relation between the Hp infection and acute myocardial infarction(AMI) was strong. The levels of Fg and TXB 2 were significantly higher in the AMI group compared with those in the NC group. Those who were Hp positive in the AMI group had not only significantly higher levels of Fg and TXB 2 than those who were Hp negative in the same group ( P <0.05)but also than those who were Hp positive in the OMI group( P <0.001).Correlation analysis revealed that the average concentration of IgG antibody to Hp was positively associated with the level of Fg in the Hp positive patients of the AMI group.Conclusion There is a significant relation between Hp infection and acute myocardial infarction? Fg?TXB 2. The relation between virulence of Hp and acute myocardial infarction was non significant.