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目的 :探讨幽门螺杆菌 (Hp)感染与冠心病 (CHD)急性心肌梗死 (AMI)的关系。方法 :测定 5 1例AMI和 4 2例陈旧性心肌梗死 (OMI)患者及 31例冠状动脉造影正常者 (对照组 )的Hp特异性抗体 (HpIgG、HpIgM)浓度 ,并同步观察血浆C 反应蛋白 (CRP)、血清脂质变化及其与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CHD危险因素前、后 ,HpIgG阳性与AMI均具有相关关系。AMI组HpIgG、总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白胆固醇 (LDL C)明显高于对照组 ;CRP高于对照组及OMI组。AMI组中Hp(+)者CRP、TG明显高于 ,HDL C明显低于Hp(- )者 (P <0 .0 5 )及OMI组中Hp(+)者 (P <0 .0 1) ;并且IgG与CRP、TC、LDL C呈正相关 ,与HDL C呈负相关 (均P <0 .0 5 ) ,调整与CRP相关的CHD危险因素后 ,IgG与CRP仍呈正相关 (P <0 .0 5 )。治疗后AMI组、AMI组中Hp(+)者CRP明显低于治疗前 (P <0 .0 5 ) ,且仍与IgG呈正相关 (P <0 .0 5 )。结论 :Hp感染与AMI之间存在明显的相关性 ,与血脂、CRP也存在相关性
Objective: To investigate the relationship between Helicobacter pylori (Hp) infection and acute myocardial infarction (AMI) in patients with coronary heart disease (CHD). Methods: Hp-specific antibodies (HpIgG, HpIgM) in 51 patients with AMI and 42 elderly patients with myocardial infarction (OMI) and 31 patients with coronary artery angiography (control group) were measured and the levels of plasma C-reactive protein (CRP), serum lipid changes and their relationship with Hp infection. Results: The positive rates of HpIgG and HpIgM in AMI group were significantly higher than those in control group (P <0.05). Before and after the correction of CHD risk factors, HpIgG positivity was correlated with AMI. HpIgG, total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL C) in AMI group were significantly higher than those in control group; CRP was higher than that in control group and OMI group. The CRP, TG of Hp (+) in AMI group were significantly higher than those in Hp (-) HDL C group and Hp (+) in OMI group (P <0.01) . There was a positive correlation between IgG and CRP, TC, LDL C and negative correlation with HDL C (all P <0.05). There was a positive correlation between IgG and CRP after adjustment for CHD risk factors associated with CRP (P <0 .0 5). After treatment, the CRP of Hp (+) in AMI group and AMI group was significantly lower than that before treatment (P <0.05), and still positively correlated with IgG (P <0.05). Conclusion: There is a significant correlation between Hp infection and AMI, and there is also correlation with serum lipids and CRP