幽门螺杆菌感染与脑梗死患者颈动脉粥样硬化斑块稳定性的关系

Relationship between helicobacter pylori infection and carotid artery plaque stability in patients with cerebral infarction

目的探讨幽门螺杆菌(Hp)感染与脑梗死患者颈动脉粥样硬化斑块稳定性的关系。方法回顾性分析了马鞍山中心医院住院治疗的104例脑梗死患者,根据颈动脉彩色超声多普勒的检查结果,将患者分为不稳定斑块组(74例)、稳定斑块组(30例),比较两组患者相关危险因素、血清C-反应蛋白、纤维蛋白原、Hp感染率。用14C-尿素呼气试验检测患者Hp的感染情况。判定上述因素对斑块稳定性的影响。结果①不稳定斑块组患者的Hp感染率(86.5%)高于稳定斑块组(63.3%),差异有统计学意义。②不稳定斑块组患者的血清C-反应蛋白(13.6±3.8)mg/L和纤维蛋白原(4.5±2.3)g/L水平高于稳定斑块组的(8.6±3.7)mg/L和(2.5±1.0)g/L,差异均有统计学意义(P<0.05)。③多因素Logistic回归分析显示,除去C-反应蛋白、纤维蛋白原等之外,Hp感染也是影响脑梗死患者颈动脉粥样硬化斑块稳定性的独立危险因素(OR=0.771,95%CI:0.368～0.951,P=0.019)。结论除去影响斑块稳定性的常见危险因素之外,Hp感染也是影响颈动脉斑块稳定性的重要因素。

Objective To investigate the relationship between Helicobacter pylori （Hp） infection and carotid artery plaque stability in patients with cerebral infarction. Methods A total of 104 patients with cerebral infarction treated in Maanshan Central Hospital were enrolled retrospectively in the study. According to color-Doppler findings, the patients were divided into either an unstable plaque group （ n = 74） and a stable plaque group （ n = 30）. The related risk factors, serum C-reactive protein, fibrinogen and tip infection rate were compared in patients of both groups. A 14C urea breath test was used to detect the Hp infection in patients. The impact of the above factors on the plaque stability was determined.Results ①The Hp infection rate （86.5%） in patients of the unstable plaque group was higher than that （63, 3% ） of the stable plaque group. The difference was statistically significant. ②The levels of serum C-reactive protein 13.6 ± 3.8 mg/L and fibrinogen 4.5 ±2, 3 g/L in the unstable plaque group were higher than those 8.6 ± 3.7 mg/L and 2.5 ± 1.0 g/L in the stable plaque group. The differences were statistically significant （ P 〈 0.05 ）. ③Muhivariate logistic regression analysis showed that apart from C-reactive protein and Fibrinogen, Hp infection was also an independent risk factor for carotid artery plaque stability in patients with cerebral infarction （OR =0.771,95% CI0.368 to0.951; P=0.019）. Conclusion Apart from the common risk factors that affecting the plaque stability, Hp infection is also an important factor for affecting carotid plaque stability.