幽门螺杆菌感染是急性冠状动脉综合征的危险因素吗？

Is Helicobacter pylori infection a risk factor for acute coronary syndromes?

作者信息

Miyazaki Motonobu, Babazono Akira, Kadowaki Ken, Kato Masumi, Takata Tohru, Une Hiroshi

机构信息

Department of Epidemiology and Preventive Medicine, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka City, Fukuoka 814-0180, Japan.

出版信息

J Infect. 2006 Feb;52(2):86-91. doi: 10.1016/j.jinf.2005.04.009.

DOI:10.1016/j.jinf.2005.04.009

PMID:15907342

Abstract

OBJECTIVES

To elucidate risk factors for acute coronary syndromes (ACS), the present study examined whether Helicobacter pylori infection is a risk factor for patients with ACS.

METHODS

We studied 33 male patients with acute coronary syndromes (ACS). All patients were incidence cases of ACS that they did not have a past history of IHD and were at the first onset of ACS. A control group was consisted of 66 males. Controls were at random selected from outpatients. All controls had normal resting electrocardiogram and had no history of IHD. H. pylori seropositivity was determined by an IgG-specific enzyme linked immunosorbent assay (ELISA). We serologically confirmed the presence of antibodies specific to the antigen CagA of H. pylori, using CagA ELISA.

RESULTS

Seropositive rate of IgG antibodies in patients with ACS was 87.9%. A rate of in controls was 66.7%. After adjustment for age, a statistically significant association was found in H. pylori seropositivity between ACS and controls (OR, 3.74; 95% CI, 1.15-12.13). This relation was also significant after adjusted for potential confounding factors (OR, 4.09; 95% CI, 1.10-15.17). Anti-CagA positive H. pylori were significantly recognized in ACS (adjusted OR, 3.58; 95% CI, 1.08-11.82). However, this significant association was disappeared after adjusted for potential confounding factors (P=0.054).

CONCLUSIONS

We confirmed a significant link between H. pylori infection and ACS. H. pylori infection is likely to be a risk factor for ACS.

摘要

目的

为阐明急性冠脉综合征（ACS）的危险因素，本研究调查幽门螺杆菌感染是否为ACS患者的危险因素。

方法

我们研究了33例男性急性冠脉综合征（ACS）患者。所有患者均为ACS发病病例，既往无缺血性心脏病（IHD）病史且为首次发生ACS。对照组由66名男性组成。对照组从门诊患者中随机选取。所有对照者静息心电图正常且无IHD病史。采用IgG特异性酶联免疫吸附试验（ELISA）测定幽门螺杆菌血清阳性率。我们使用CagA ELISA血清学确认了幽门螺杆菌抗原CagA特异性抗体的存在。

结果

ACS患者IgG抗体血清阳性率为87.9%。对照组的这一比率为66.7%。在对年龄进行校正后，发现ACS与对照组之间幽门螺杆菌血清阳性存在统计学显著关联（比值比[OR]，3.74；95%置信区间[CI]，1.15 - 12.13）。在对潜在混杂因素进行校正后，这种关系也具有显著性（OR，4.09；95% CI，1.10 - 15.17）。在ACS患者中，抗CagA阳性的幽门螺杆菌得到显著确认（校正OR，3.58；95% CI，1.08 - 11.82）。然而，在对潜在混杂因素进行校正后，这种显著关联消失（P = 0.054）。