外周血嗜酸性粒细胞水平与合并幽门螺杆菌感染的急性心肌梗死的关系

摘要

Objective: To study the relationship betweenperipheral blood eosinophil(EOS) level and acute myocardial infarction(AMI) combining helicobacter pylori (Hp) infection, to compare EOS level in Hp(+) and Hp(-) AMI patients with the possible mechanism. Methods: A total of 662 patients with coronary heart disease(CHD) admitted in our hospital from 2015-09 to 2016-05 were retrospectively studied. The patients were divided into 2 groups: AMI group, n=269 and Stable angina pectoris(SAP) group, n=393; according to 13C breath test, the patients were divided into another set of 2 groups: Hp(+) group, Hp infection value≥4.0, n=276 and Hp(-) group, Hp infection value<4.0, n=386. Clinical data was collected, EOS levels were compared between Hp(+) and Hp(-) AMI patients; relationship between EOS level and high sensitivity C-reactive protein(hs-CRP) level was analyzed in Hp(+) AMI patients. Results: Compared with SAP group, AMI group had the higher rate of Hp(+) as 46.5%vs38.4%, P=0.024. In Hp(+) group, compared with SAP patients, AMI patients had the lower EOS level and higher hs-CRP level, all P<0.000. In Hp(+) AMI patients, EOS level was negatively related to hs-CRP(r=-0.202, P<0.05). Conclusion:Hp(+) AMI patients had decreased peripheral blood EOS and increased hs-CRP, it implied that Hp(+) may aggravate the inflammatory response in AMI patients and therefore, affect EOS which could play an important role in thrombus formation.%目的:研究外周血嗜酸性粒细胞(EOS)水平与合并幽门螺杆菌(Hp)感染的急性心肌梗死(AMI)的关系,比较外周血EOS的水平在合并有Hp(+)与Hp(-)的AMI患者中的不同,探讨Hp(+)在其中可能的作用及作用机制.方法:回顾性分析2015-09至2016-05在我院住院治疗的冠心病患者共662例,其中AMI患者269例(AMI组),稳定性心绞痛(SAP)患者393例(SAP组).所有患者均行13C呼气试验,再分为Hp(+)组(n=276,Hp感染值≥4.0)和Hp(-)组(n=386,Hp感染值<4.0).收集患者临床资料,比较Hp(+)和Hp(-)AMI患者外周血EOS的水平,分析Hp(+)AMI患者外周血EOS水平与超敏C-反应蛋白(hs-CRP)的关系.结果:AMI组Hp(+)阳性率为46.5%,高于SAP组的38.4%,差异有统计学意义(P=0.024).Hp(+)组中AMI患者外周血EOS水平明显低于SAP患者,hs-CRP水平高于SAP患者,差异均有统计学意义(P均=0.000).Hp(+)AMI患者外周血EOS与hs-CRP呈负相关(r=-0.202,P=0.024,P<0.05).结论:Hp(+)AMI患者外周血EOS水平明显减低、hs-CRP水平升高,EOS与hs-CRP之间呈负相关.考虑Hp(+)可能通过加重AMI的炎症反应影响外周血中EOS水平,EOS可能在血栓形成中发挥重要作用.