幽门螺杆菌阳性对缺血性脑卒中患者阿司匹林依从性的影响研究

Influence of Helicobacter Pylori- positive on Aspirin Compliance Among Patients With Cerebral Ischemic Stroke

目的探讨幽门螺杆菌(Hp)阳性对缺血性脑卒中患者阿司匹林依从性的影响。方法选取2013年5月—2014年12月在首都医科大学附属北京天坛医院神经内科门诊就诊且口服阿司匹林的缺血性脑卒中患者200例,以其中按要求完成随访的188例为研究对象。根据^(14)C-尿素呼气试验(^(14)C-UBT)结果,将其分为Hp阳性组(n=62)和Hp阴性组(n=126),两组均规律口服阿司匹林1年。结果 Hp阳性组和Hp阴性组患者性别、平均年龄、文化程度、家庭月收入、医保类型及合并症比较,差异无统计学意义(P>0.05)。两组阿司匹林6个月依从性比较,差异有统计学意义(P<0.05);而阿司匹林1年依从性比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,Hp感染情况对阿司匹林6个月依从性的影响有统计学意义〔OR(95%CI)=2.125(1.206,3.745),P=0.003〕,但对阿司匹林1年依从性的影响无统计学意义〔OR(95%CI)=1.124(0.846,1.493),P=0.123〕。结论 Hp感染情况是缺血性脑卒中患者短期阿司匹林依从性的影响因素,Hp阳性患者的依从性较低。在缺血性脑卒中患者服用阿司匹林前,常规筛查Hp并进行正规根除Hp治疗,可提高其阿司匹林依从性。

Objective To investigate the influence of Helicobacter pylori（ Hp） - positive on aspirin compliance among patients with cerebral ischemic stroke. Methods We enrolled 200 patients with cerebral ischemic stroke who received treatment and were orally administrated with aspirin in the outpatient Department of the Neurology of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2013 to December 2014,and 188 patients who completed follow - up as required were enrolled as research objects. According to ^14 C-UBT result,the subjects were divided into Hp - positive group（n= 62）and Hp - negative group（n = 126）. The two groups were both orally administrated with aspirin for one year. Results The two groups were not significantly different in gender,average age,education level,monthly family income,category of medical insurance and complications（P 〉 0. 05）. The two groups were significantly different in 6 - month compliance（P 〈0. 05）,while the two groups were not significantly different in one - year complianc（P 〉 0. 05）. Logistic regression analysis showed that Hp - positive status had significant influence on 6 - month aspirin compliance〔OR（95% CI） = 2. 125（1. 206, 3. 745）,P = 0. 003〕,but had no significant influence on one - year aspirin compliance〔 OR（95% CI） = 1. 124（0. 846, 1. 493）,P = 0. 123〕. Conclusion Hp - positive is an influencing factor for short - term aspirin compliance of patients with cerebral ischemic stroke,the compliance of Hp - positive patients is at low level. Before the administration of aspirin, conventional screening of Hp and eradication of Hp treatment could improve aspirin compliance.