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目的探讨幽门螺杆菌(Hp)感染类型与冠心病发生、冠脉斑块类型及冠心病患者临床预后的关系。方法选取本院2014年11月-2015年11月经冠脉造影确诊为冠心病的患者120例为观察组,同期120例健康体检者为对照组,采用酶联免疫吸附法检测患者血清中Hp特异性抗体Cag A类型,并检测患者Hp感染与冠脉斑块类型的关系,用Logistics回归分析探讨冠心病患者预后不良的风险因素。结果 Hp阳性患者冠心病风险为阴性患者的2.8倍、Hp+Cag A-Ig G阴性患者冠心病风险比为2.5,而Hp+Cag A-Ig G阳性冠心病风险为Hp阴性患者的3.3倍,Hp阴性的冠心病患者软斑块16例,占64.0%,明显高于Hp+Cag A-Ig G阴性和Hp+Cag A-Ig G阳性的患者,而纤维斑块6例,占24.0%、钙化斑块3例,占12.0%,均明显低于Hp+Cag A-Ig G阴性和Hp+Cag A-Ig G阳性的患者。Hp+Cag A-Ig G阳性、软斑块是患者心血管事件的独立风险因素。结论 Hp感染患者冠心病风险明显增加,而Hp+Cag A-Ig G阳性是冠心病患者软斑块和心血管事件的独立风险因素。
Objective To investigate the relationship between the type of Helicobacter pylori (Hp) infection and the occurrence of coronary heart disease, coronary artery plaque type and clinical prognosis in patients with coronary heart disease. Methods One hundred and twenty patients diagnosed as coronary heart disease by coronary angiography from November 2014 to November 2015 in our hospital were selected as the observation group and 120 healthy people as the control group during the same period. Enzyme-linked immunosorbent assay was used to detect the serum Hp-specific Sex antibody Cag A type and detection of Hp infection in patients with coronary plaque type of relationship between the use of Logistics regression analysis of coronary heart disease patients with poor prognosis risk factors. Results The risk of coronary heart disease in Hp positive patients was 2.8 times of that in patients with negative Hp + Cag A-Ig G, and the risk of Hp + Cag A-Ig G positive coronary artery disease was 3.3 times of that in Hp negative patients. Sixteen soft plaques in Hp-negative patients with coronary heart disease (64.0%) were significantly higher than those in Hp + Cag A-Ig G-negative and Hp + Cag A-Ig G positive patients. Three cases of calcified plaque (12.0%) were significantly lower than Hp + Cag A-Ig G-negative and Hp + Cag A-Ig G-positive patients. Hp + Cag A-Ig G positive, soft plaque is an independent risk factor for cardiovascular events in patients. Conclusions The risk of coronary heart disease in patients with Hp infection is significantly increased, while the Hp + Cag A-Ig G positive is an independent risk factor for soft plaque and cardiovascular events in patients with coronary heart disease.