Relationship between Helicobacter pylori infection and upper gastrointestinal hemorrhage induced by anti-platelet therapy in patients with coronary heart disease
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摘要: [目的]探讨幽门螺杆菌(Hp)感染与冠心病(CHD)患者抗血小板治疗后发生上消化道出血的相关性,并观察根治Hp预防上消化道出血的效果。[方法]120例Hp阳性的CHD患者和30例Hp阴性患者(Hp阴性组)纳入研究,均行抗血小板治疗。Hp阳性患者随机分为2组,各60例,观察组给予Hp根除治疗,并在4周后观察治疗效果。所有患者随访1年,比较各组上消化道出血事件发生率的差异。[结果]对照组上消化道出血发生率为11.67%(7/60),高于观察组1.67%(1/60)和Hp阴性组的0(P<0.05)。观察组行Hp根除治疗后仍有5%(3/60)为阳性,其中1例发生上消化道出血,而95%(57/60)转为阴性,且无上消化道出血发生(P<0.05)。[结论]Hp感染可增加CHD患者抗血小板治疗时发生上消化道出血的风险,而根除Hp治疗能使出血风险降低。Abstract: [Objective][WT5BZ]To investigate the correlation of Helicobacter pylori (Hp) infection with upper gastrointestinal hemorrhage after anti-platelet therapy in patients with coronary heart disease (CHD),and [HT]
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Key words:
- [Objective]To investigate the correlation of Helicobacter pylori (Hp) infection with upper gastrointestinal hemorrhage after anti-platelet therapy in patients with coronary heart disease (CHD),and the effect of eradicating Hp therapy for treating upper gastrointestinal hemorrhage.[Methods] One hundred and twenty cases of Hp positive CHD patients and 30 cases of Hp negative CHD patients who underwent anti-platelet therapy were enrolled in this study.The Hp positive patients were randomly divided into observation group and control group with 60 cases in each group.The observation group was given eradicating Hp therapy,and the therapeutic effects were observed after 4 weeks.All patients were followed up for 1 year,and the incidence of upper gastrointestinal hemorrhage events was observed and the difference among the groups was compared.[Results]The incidence of upper gastrointestinal hemorrhage in the control group was 11.67% (7/60),which was higher than 1.67% (1/60) in observation group and 0 in Hp negative group, respectively,and the difference had statistical significance (P<0.05).After 4 weeks of eradicating Hp therapy in observation group,there were 5% (3/60) patients remaining Hp positive,including 1 cases of upper gastrointestinal hemorrhage /
- and 95% (57/60) patients turned Hp negative,and no upper gastrointestinal hemorrhage occurred. The difference was statistically significant (P<0.05).[Conclusion]Hp infection can increase the risk of upper gastrointestinal hemorrhage in CHD patients with anti-platelet therapy,and eradicating Hp therapy can reduce this risk. /
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[1] CHRISTODOULOU D K, MILIONIS H J, PAPPA P, et al.Association of Helicobacter pylori infection with cardiovascular disease-is it just a myth?[J].European J Int Med, 2011, 22:191-194.
[2] 刘明瑜.幽门螺杆菌感染与冠心病关系的探讨[J].中华医院感染学杂志, 2011, 21 (8):1599-1601.
[3] 颜红兵, 马长生.美国冠心病诊断与治疗指南[M].北京:中国环境科学出版社, 2006:11-43.
[4] 《中华内科杂志》编委会, 《中华消化杂志》编委会, 《中华消化内镜杂志》编委会, 等.急性非静脉曲张性上消化道出血诊治指南 (2009, 杭州)[J].中华内科杂志, 2009, 48 (10):891-894.
[5] ZHANG A, ZHEENG W, LI J.Study of the risk factors of postoperative upper gastrointestinal bleeding of percutaneous coronary interventional therapy[J].Life Sci J, 2009, 6:63-64.
[6] 刘亚军, 李文放, 林茂恩, 等.冠心病患者上消化道出血后停用阿斯匹林与近期心血管事件的关系[J].临床心血管病杂志, 2011, 27 (1):19-21.
[7] Antithrombotic Trialists'Collaboration.Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients[J].BMJ, 2002, 324 (7329):71-86.
[8] RODRIGUEZ L A G, LIN K J, HERNANDEZ-DIAZ S, et al.Risk of upper gastrointestinal bleeding with low-dose acetylsalicylic acid alone and in combination with clopidogrel and other medications[J].Circulation, 2011, 123:1108-1115.
[9] IBANEZ L, VIDAL X, LVENDERL L, et al.Upper gastrointestinal bleeding associated with anti-platelet drugs[J].Aliment Pharmacol Ther, 2006, 23:235-242.
[10] 先进, 金立军.幽门螺杆菌感染与冠心病相关性的研究进展[J].医学综述, 2010, 16 (2):244-248
[11] IJIMA K, ARA N, ABE Y, et al.Biphasic effects of H.pylori infection on low-dose aspirin-induced gastropathy depending on the gastric acid secretion level[J].J Gastroenterol, 2012, 47:1290-1297.
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