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目的探讨幽门螺杆菌(Hp)感染与冠心病经皮冠状动脉介入治疗(PCI)后抗血小板治疗诱发上消化道出血的关系。方法行PCI术冠心病患者520例,围术期均给予氯吡格雷和阿司匹林抗血小板治疗。Hp检测结果:410例Hp感染阳性(A组),110例Hp阴性(B组)。A组患者随机均分为两组:A1组采用规范三联用药方案实施Hp根除治疗,A2组未予抗Hp治疗。治疗后随访1年,观察上消化道出血发生情况。结果 A组上消化道出血发生率为6.83%,B组未出现上消化道出血病例。A1组上消化道出血发生率为1.46%,低于A2组的12.20%(P<0.05)。结论 Hp感染增加冠心病患者PCI术后抗血小板治疗发生上消化道出血的风险,抗Hp治疗能有效降低这种风险。
Objective To investigate the relationship between Helicobacter pylori (Hp) infection and anti-platelet therapy-induced upper gastrointestinal bleeding after percutaneous coronary intervention (PCI) in patients with coronary heart disease. Methods A total of 520 patients with coronary artery disease undergoing PCI were treated with antiplatelet therapy with clopidogrel and aspirin during the perioperative period. Hp test results: 410 cases of Hp infection (A group), 110 cases of Hp negative (B group). Patients in group A were randomly divided into two groups: Group A1 was treated with Hp eradication by standard triple regimen, and group A2 was not treated with anti-Hp. Followed up for 1 year after treatment to observe the occurrence of upper gastrointestinal bleeding. Results The incidence of upper gastrointestinal bleeding in group A was 6.83%. There was no upper gastrointestinal bleeding in group B. The incidence of upper gastrointestinal bleeding in group A1 was 1.46%, lower than 12.20% in group A2 (P <0.05). Conclusion Hp infection increases the risk of upper gastrointestinal bleeding after anti-platelet therapy in patients with coronary heart disease. Anti-Hp therapy can effectively reduce this risk.