幽门螺杆菌感染与急性心肌梗死的关系

Relation between Helicobacter Pylori Infection and Acute Myocardial Infarction

为探讨幽门螺杆菌感染与冠心病心肌梗死的关系。将 93例心肌梗死患者分为两组 :急性心肌梗死组5 1例 ,陈旧性心肌梗死组 4 3例。分别测定患者的幽门螺杆菌特异性抗体 (IgG和IgM)浓度 ,并同步观察血浆C反应蛋白和纤维蛋白原变化及其与幽门螺杆菌感染的相关性 ;同时与 31例冠状动脉造影正常者进行比较。结果发现 ,急性心肌梗死组幽门螺杆菌IgG阳性率及平均浓度 ,IgM阳性率及吸光度值明显高于正常对照组 (P <0 .0 5 ) ,与陈旧性心肌梗死组比较差异不显著 (P >0 .0 5 )。未校正冠心病危险因素时 ,幽门螺杆菌IgG阳性与急性心肌梗死组具有相关关系 (OR为 3.0 4 7,95 %CI为 1.0 5 5～ 8.796 ,χ2 为 2 4 .2 4 1,P =0 .0 3) ,校正后二者仍有相关关系 (OR为 3.2 6 2 ,95 %CI为 1.0 15～ 10 .4 85 ,χ2 为 2 3.94 ,P =0 .0 4 7)。急性心肌梗死组幽门螺杆菌IgG明显高于正常对照组 (P <0 .0 5 ) ;纤维蛋白原和C反应蛋白明显高于正常对照组 (P <0 .0 0 1) ;纤维蛋白原高于陈旧性心肌梗死组P <0 .0 0 1) ;C反应蛋白高于陈旧性心肌梗死组 (P <0 .0 5 )。急性心肌梗死组中幽门螺杆菌 (+)者纤维蛋白原和C反应蛋白明显高于幽门螺杆菌 ( )者 (P <0 .0 5 )及陈旧性心肌梗死组幽门螺杆菌 (+)者 (P <0 .0 0 1) ;并且IgG与纤维?

Aim To investigate the relations between Helicobacter pylori(Hp) infection and acute myocardial infarction. Methods The concentration of Hp specific IgG antibody and the optical density (OD) of Hp specific IgM antibody 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) who had angiographically confirmed no coronary artery disease. Simultaneously, the changes and relationships between C-reative protein (CRP), fibrinogen (Fg) and Hp infection were determined in the three groups. Results 39 of the AMI group (76.47%) were seropositive for Hp average concentration (OD) of IgG (IgM) antibody to Hp was significantly higher in the AMI group than that of the NC group (P<0.05), but they were not significantly higher than that of the OMI group (P<0.05). The relation between the Hp infection and acute myocardial infarction (AMI) was strong (odd ratio is 3.047, 95%CI is from 1.055 to 8.796, χ 2=24.241, P=0.03). Adjustment for the major cardiovascular risk factors didn't attenuate this relation (odds ratio is 3.262, 95%CI is from 1.015 to 10.485, χ 2=23.94, P=0.047). The average concentration of IgG antibody to Hp, the levels of Fg and CRP 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 hiher levels of CRP and Fg 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). There was still a positive relation with the average contentration of IgG to Hp in Hp positive patients of the AMI group (P<0.05). Conclusion There is a significant relation between Hp infection and acute myocardial infarction. There is a certain relation between Fg, CRP and Hp infection, too.