Objective:To investigate the correlation of Helicobacter pylori (Hp) infection and upper gastrointestinal hemorrhage by anti-platelet therapy in patients with coronary heart disease,and observe the effect of Hp eradication to prophylaxis upper gastrointestinal hemorrhage.Methods:420 patients with unstable coronary heart disease;according to 14C breath test,patients were divided into Hp positive groups(270 cases) and Hp negative group(150 cases);Hp positive group were further divided into Hp positive treatment group (170 cases) and Hp positive non-treatment group (100 cases);all patients adopted conventional clopidogrel and aspirin to carry out antiplatelet treatment,Hp positive treatment group adopted 4 combination medication therapy to eradicate Hp;3 groups of patients were followed-up for one year,and recording UGI hemorrhage and anemia situation,testing creatinine,ALT,PT,Hb content;recording repeated angina pectoris,non-fatal myocardial infarction and heart failure adverse incidence rate.Results:1 year follow-up visit showed that 17 Hp positive patients (6.30％)was found upper gastrointestinal hemorrhage in treatment group (3 cases,1.76％) and non-treatment group (14,14％);Hp negative group found no cases of upper gastrointestinal hemorrhage,Hp positive untreated patients were found with higher incidence rate of upper gastrointestinal hemorrhage than Hp positive treated patients and negative group (P ＜ 0.05);compared with Hp negative group and Hp positive group treatment group,there was increased incidence rate of anemia and decreased Hb content in Hp positive untreated group (P ＜ 0.05),while anemia incidence rate and Hb content comparison of Hp positive treatment group and Hp negative group showed no statistical significance (P ＞ 0.05);PT,creatinine and ALT level comparison of three groups showed no statistical significance (P ＞ 0.05);1 year follow-up visit after treatment showed that repeated angina pectoris,non-fatal myocardial infarction and heart failure adverse incidence rate no statistical significance(P ＞ 0.05).Conclusion:Helicobacter pylori infection can increase the risk of upper gastrointestinal hemorrhage in coronary heart disease,and eradicating Hp therapy can reduce this risk and improve anemia degree.%目的:探讨幽门螺杆菌(Hp)感染与冠心病患者抗血小板药物治疗后发生上消化道出血的关系,观察根除Hp对降低此类患者上消化道出血风险的效果.方法:420例冠心病不稳定心绞痛患者,根据C-14尿素呼气试验结果分为Hp阳性组(n=270)和Hp阴性组(n=150),又将Hp阳性组分为Hp阳性治疗组(n=170)和Hp阳性未治疗组(n=100),所有患者均采用常规氯吡格雷、阿司匹林进行抗血小板治疗,Hp阳性治疗组患者采用四联用药方案进行Hp根除治疗;3组患者于治疗后1年时随访,记录上消化道出血和贫血情况、检测血肌酐、谷丙转氨酶(ALT)、血浆凝血酶原时间(PT)、血红蛋白(Hb)含量,记录再发心绞痛、非致死性心肌梗死和心力衰竭心脏不良事件发生率.结果:1年时随访结果显示,17例Hp阳性患者(6.30％)发生上消化道出血,其中Hp阳性治疗组3例(1.76％),Hp阳性未治疗组14例(14％),Hp阴性患者无上消化道出血病例,Hp阳性未治疗组患者上消化道出血发生率高于Hp阳性治疗组和Hp阴性组(P＜0.05);与Hp阴性组和Hp阳性治疗组比较,Hp阻性未治疗组贫血发生率增高、Hb含量降低(P＜0.05),而Hp阳性治疗组与Hp阴性组患者贫血发生率及Hb含量比较差异无统计学意义(P＞0.05);3组患者PT、血肌酐及ALT水平比较,差异无统计学意义(P＞0.05);3组患者治疗后1年时的随访结果显示,Hp阴性、Hp阳性治疗和未治疗患者再发心绞痛、非致死性心肌梗死及心力衰竭心脏不良事件发生率比较,差异无统计学意义(P＞0.05).结论:抗Hp治疗可降低冠心病合并Hp感染抗血小板治疗患者上消化道出血的风险,改善贫血程度.
展开▼
