在急性心肌梗塞后的Helicobacter pylori查:集群随机交叉HELP-MI SWEDEHEART试验
Robin Hofmann1, Stefan James2,3, Martin O Sundqvist1
1Department of Clinical Science and Education, Division of Cardiology, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
JAMA
|September 1, 2025
概括
在心肌梗塞患者中,常规查Helicobacter pylori并没有显著降低上胃肠道出血的风险. 需要进一步的研究,以探索特定患者亚组的潜在益处.
科学领域:
- 心脏病学
- 胃肠病学
- 传染病流行病学
背景情况:
- 上部胃肠道出血是心肌梗塞后的一个严重并发症.
- 杆菌感染是已知的胃肠道问题的危险因素.
研究的目的:
- 评估心肌梗塞住院期间的常规Helicobacter pylori查是否会减少出血事件.
- 评估H. pylori查对心肌梗塞患者临床结果的影响.
主要方法:
- 一个全国性的,随机的,交叉试验,涉及35个瑞典医院.
- 患有急性心肌梗塞的患者被分配到常规H. pylori查或常规护理.
- 从临床登记册和国家健康数据收集的数据,后续调查至2025年1月.
主要成果:
- 在H. pylori查组中没有显著减少上部胃肠道出血 (比率比,0. 90;P=. 18).
- 在中度至重度贫血的小组中发现了潜在的益处 (相互作用的P=.03).
- 在查期间检测到的患者中有23. 6%的H. pylori.
结论:
- 在未经选择的急性心肌梗塞患者中,常规的H. pylori查没有显著降低上部胃肠道出血的风险.
- 这些发现表明,例行查可能不对所有患者有益,但亚组效应需要进一步调查.
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