抗幽门螺杆菌治疗对急性脑梗死患者预后的影响

Effect of anti-Helicobacter pylori on the prognosis in patients with acute cerebral infarction

目的:探讨抗幽门螺杆菌治疗对急性脑梗死患者(acute cerebral infarction,ACI)炎症介质及预后的影响。方法:对收治我院的急性脑梗死病人常规做尿素酶试验,将尿素酶试验阳性的急性脑梗死患者随机分为治疗组和对照组,2组患者均给予常规药物治疗,治疗组患者加用抗幽门螺杆菌治疗。2组患者治疗前后观察C反应蛋白(C-reactive protein,CRP)、三酰甘油(triglycerides,TG)、血浆纤维蛋白原(plasma fibrinogen,FIB)变化,并观察2组患者的急性脑梗死症状缓解情况及半年内、1年内的脑梗死再住院率。结果:治疗组患者的CRP、三酰甘油、血浆纤维蛋白原较治疗前显著下降,而对照组患者则变化不明显;治疗组患者半年内及1年内因脑梗死再住院率显著低于对照组。结论:幽门螺杆菌感染可能是脑梗死的发病因素,积极抗幽门螺杆菌感染治疗,可显著提高脑梗死治疗的有效率,并可降低其短期内因脑梗死住院的再次住院率。

Objective To investigate the effect of anti-Helicobacter pylori on the inflammation mediators and prognosis in patients with acute cerebral infarction. Methods Routine urease test was carried out in patients with acute cerebral infarction in our hospital. The acute cerebral infarction patients with positive urease test were randomly divided into a treatment group （conventional therapy ＋ anti-Helicobacter pylori therapy） and a control group （ conventional therapy）. C-reactive protein, triglycerides, and fibrinogen changes were examined before and after the treatment, symptoms of acute cerebral infarction conditions were observed, and 6-months and 1- year cerebral infarction readmission rates were measured in the 2 groups. Results Compared with before the treatment, the C-reactive protein, triglycerides, and plasma fibrinogen decreased significantly in the treatment group, while there was no significant change in the control group. The 6-months and 1- year cerebral infarction readmission rates were significantly lower than those in the control group. Conclusion H. pylori infection may be a risk factor for cerebral infarction. A positive anti-Helico- bacter pylori infection treatment can significantly improve the efficiency of cerebral infarction and reduce the short-term readmission rate.