幽门螺杆菌感染和超敏C-反应蛋白及同型半胱氨酸水平与缺血性脑卒中的关系

Relationship between Helicobacter pylori infection, high sensitive C reactive protein, homocysteine and ischemic stroke

目的 探讨幽门螺杆菌（Hp）感染、超敏C-反应蛋白（Hs-CRP）及同型半胱氨酸（Hcy）水平与缺血性脑卒中的关系.方法 选择2010年11月至2012年11月确诊的缺血性脑卒中患者150例为研究对象,另选取同时间段进行常规体检的人群100例做为对照组.采用酶联免疫吸附法、散射比浊法和循环酶法检测HPIgG、Hs-CRP和Hcy的表达水平,分析Hp感染与血清Hs-CRP、Hcy表达水平之间的关系.结果 缺血性脑卒中患者Hp感染阳性率明显高于对照组,差异有统计学意义（80％ vs 39％,P＜0.05）;Hp感染阳性缺血性脑卒中患者的血清Hs-CRP水平及Hcy水平明显高于Hp感染阴性患者,差异有统计学意义[（43.15±5.61） mg/L vs（28.69±2.13） mg/L、（26.21±5.83） mmol/L vs（16.82±6.31） mmol/L,P＜0.05];直线相关分析结果显示,HPIgG阳性率、Hs-CRP、Hcy表达水平和缺血性脑卒中病情分级呈正相关（r值分别为0.73、0.85、0.89,P均＜0.05）.结论 Hp感染与Hs-CRP和Hcy水平升高可能在缺血性脑卒中的疾病发生、发展中起重要作用,三者可能是缺血性脑卒中发生的危险因素。

Objective To investigate the relationship between Helicobacter pylori infection,high sensitive C reactive protein,homocysteine and ischemic stroke.Methods From November 2010 to November 2012,150 patients with ischemic stroke newly diagnosed were selected as the study objects,and 100 people for routine check-up during the same time were selected as control group.Using enzyme-linked immunosorbent assay,scattering ratio turbidimetry and enzymatic cycling assay,the expression levels of HPIgG,Hs-CRP and Hcy were detected.The relationship between Hp infection and serum Hs-CRP,Hcy levels was analyzed.Results The Hp infection positive rate of patients with ischemic cerebral stroke was obviously higher than that of the patients in the control group,there were significant differences （80％ vs 39％,P ＜ 0.05） ; The serum Hs-CRP levels and Hcy levels of the ischemic stroke patients with Hp infection were higher than those without Hp infection,there were significant differences [（43.15 ± 5.61） mg/L vs （28.69 ± 2.13） mg/L,（26.21 ± 5.83） mmol/L vs（16.82 ±6.31）mmol/L,P ＜0.05].Linear correlation analysis showed that the positive rate of HPIgG,and the expression levels of Hs-CRP,Hcy were positively correlated with ischemic stroke （r =0.73,0.85,0.89,P ＜ 0.05）.Conclusions Hp infection and elevated levels of Hs-CRP and Hcy may play an important role in the occurrence and development of ischemic stroke,they may be the risk factors of ischemic stroke.