天坛医院学者称:幽门螺旋杆菌感染增加急性心梗风险

2018-01-02 卢芳 中国循环杂志

一提幽门螺旋杆菌(HP),通常会想到胃部疾病,但实际上HP感染还会参与心梗的发生。


一提幽门螺旋杆菌(HP),通常会想到胃部疾病,但实际上HP感染还会参与心梗的发生。
 
近期,首都医科大学附属北京天坛医院王德昭、陈蕾蕾等通过对比合并或不合并HP感染的急性心梗患者发现,HP感染可能还通过加重炎症反应影响外周血中嗜酸性粒细胞水平,而后者或在血栓形成中发挥重要作用。
 
研究显示,心梗患者中有46.5%的人感染了HP,显著高于稳定性心绞痛患者的38.4%。
 
而那些感染HP的心梗患者外周血嗜酸性粒细胞水平却明显降低,高敏C反应蛋白明显升高,二者呈负相关。
 
研究者介绍说,HP通过引起机体持续低度炎性反应及宿主肽蛋白的分子表达模拟机制等来参与胃肠外疾病(缺铁性贫血、特发性血小板减少性紫癜、心血管疾病、肝胆疾病、神经性疾病、代谢性疾病等)的发生发展。
 
就急性心梗而言,既往研究表明Hp可能通过促进血小板聚集、直接定植于冠脉血管壁、抗原模拟机制导致自身免疫激素聚集从而损伤血管内皮以及炎症反应等促发心梗。
 
此外,结合多项研究,提示HP感染或是急性心梗的独立危险因素。
 
而高敏C反应蛋白,不仅是急性心梗事件发生时急性期血清炎症反应标记物,也可能作为炎症因子在急性心梗事件参与血栓形成。本项研究则显示,感染HP者,其高敏C反应蛋白升高。
 
此外,之前有多项研究在冠脉血栓中发现大量嗜酸性粒细胞浸润。
 
研究者推测,HP可能通过参与炎症反应影响外周血嗜酸性粒细胞水平,减少的外周血嗜酸性粒细胞可能转移至冠脉内,进而参与血栓形成,导致急性心梗发生。
 
该研究共纳入662例冠心病患者,其中急性心梗患者269例,稳定性心绞痛393例;HP感染阳性者276例,阴性组36例。
 

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