Evaluation On Efficacy In Eradicating Helicobacter Pylori In Patients With Coronary Heart Disease Complicated With Helicobacter Pylori Infection

Purpose:To explore the effect of helicobacter pylori eradication on the standard treatment of coronary heart disease.Methods:Included a total of 168 patients hospitalized in 1^staffiliated hospital of University of South China during Apr.2016 to Sept.2017 who diagnosed with CHD by coronary angiography and HP infection by ¹⁴C-urea breath test,and finally 110 patients were selected by following the research standards strictly.Divide them into 2 groups differentiated by treatment methods with 56 cases of conventional treatment plus HP eradicate（Combined-therapy group）and 54 cases of conventional treatment solely.Conventional CHD treatment plan:aspirin（100mg,1times/d）+atorvastatin（20mg,1times/d）+metoprololand（47,5mg,1times/d）+benazepril（5mg,1times/d）+trimetazidine（20mg,3times/d）+give symptomatic relief and supportive treatment,and perform PCI surgery if necessary.The treatment of HP eradication:lansoprazole（30mg,2times/d）+amoxicillin（1000mg,2times/d）+clarithromycin（500mg,2times/d）+bismuth potassium citrate（220mg,2times/d）,treatment period is 14 days.Collected general clinical data,carotid colour doppler ultrasonography results,follow-up records of rehospitalization times for CHD and Clinical symptoms improved in half a year in two groups respectively.Investigated the effect of helicobacter pylori eradication on the standard treatment of coronary heart disease.Results:（1）Before the treatment,there are statistically insignificant in two groups in terms of the CHD traditional risk factors:sex,age,body mass index（BMI）,total cholesterol（TC）,total triglyceride（TG）,lowdensitylipoproteincholesterol（LDL-C）,high-densitylipoproteincholesterol（HDL-C）,homocysteine（HCY）,diabetes,hypertension,family history of CHD,smoking,etc.（P>0.05）.（2）Compare two groups after different treatments,the values of NLR,CRP,FIB and LDL-C were decreased,the difference was statistically significant,the combined treatment group was better than the conventional treatment group（P<0.05）;the effects of treatment with TC,TG and HDL-C were similar,the difference was not statistically significant（P>0.05）.（3）After 6 months of treatment,the detection rates of carotid plaque in the combined treatment group and the conventional treatment group were 85.7%and 83.3%respectively.The stable plaque ratios were 89.6%and 68.9%respectively.There was no significant difference in the detection rate of carotid plaque after treatment between the two groups（χ²=0.119,p=0.730）;the stability of carotid plaque after treatment was different between the two groups,and there was a statistically significant difference,the stability of carotid plaque in the combined treatment group was better than the conventional treatment group（χ²=6.119 p=0.013）;the difference rangeability of CIMT values between the two groups was not statistically significant（F=0.210,P=0.889）.（4）The rate of rehospitalization regarding CHD within six months in the combined treatment group and the conventional treatment group were8.9%and 24.1%respectively,the improvement rate of clinical symptoms in the two groups was 89.3%and 72.2%respectively,it’s statistically significant whether patients got rehospitalized due to CHD within six months between the 2 groups,the rehospitalization in the combined treatment group was lower than the conventional treatment group（χ²=4.608,p=0.032）;and the improvement rate of clinical symptoms in the two groups was statistically significant,the combined treatment group was better than the conventional treatment group（χ²=5.182,p=0.023）.Conclusion:1.Combined eradication of HP may lower the level of NLR,CRP,FIB and LDL-C in CHD patients effectively.2.Combined eradication of HP may contribute to the formation of stable plaque in carotid artery in CHD patients.3.Combined eradication of HP may be more effective in relieving the clinical symptoms of CHD patients,and reduce the rate of rehospitalization.