抗幽门螺旋杆菌治疗对急性脑梗死患者氧化应激水平及预后的影响

Effect of Anti-Helicobacter Pylori on the Level of Oxidative Stress and Prognosis in Patients with Acute Cerebral Infarction

目的探讨抗幽门螺旋杆菌(Hp)治疗对急性脑梗死(ACI)患者氧化应激水平及预后的影响。方法ACI患者125例,常规做14C尿素呼气试验检测Hp感染情况。将84例Hp感染患者随机分为治疗组42例和对照组42例,两组均给予常规药物治疗,治疗组加用抗Hp治疗。采用酶联免疫吸附法检测所有患者血清氧化型低密度脂蛋白(ox-LDL)和超氧化物歧化酶(SOD)水平,观察两组患者治疗前后ox-LDL和SOD变化,观察其神经功能恢复情况,随访半年、1年统计脑梗死复发率。结果 125例ACI患者中Hp感染率为67.2%。随着Hp感染程度加重,血清ox-LDL水平升高(F=16.143,P<0.01),SOD水平下降(F=55.686,P<0.01)。治疗组治疗后血清ox-LDL水平较对照组降低,SOD水平较对照组升高(P<0.01)。治疗组神经功能恢复总有效率高于对照组(P<0.01)。治疗组半年及1年脑梗死复发率均低于对照组(P<0.05)。结论 Hp感染是ACI的重要危险因素,积极抗Hp治疗,可显著降低脑梗死患者体内氧化应激反应,提高治疗的有效率,并可降低其短期内脑梗死的复发率。

Aim To explore the effect of anti-Helicobacter pylori（Hp） on the oxidative stress related indicators and prognosis in patients with acute cerebral infarction（ACI）.Methods In 125 cases of patients with ACI,routine14 C urea breath test was performed to detect Hp infection.84 cases of Hp infection were randomly divided into treatment group of 42 cases and control group of 42 cases.Two groups were given conventional drug therapy,and treatment group was added with anti-Hp therapy.Serum oxidized low density lipoprotein（ox-LDL） and superoxide dismutase（SOD） levels in all patients were detected by enzyme-linked immunosorbent assay（ELISA）.The changes of ox-LDL and SOD were observed before and after treatment in the two groups.The neural function recovery was observed,and the recurrence rate of cerebral infarction was observed in half year and 1 year.Results Hp infection rate was 67.2% in 125 patients with ACI.With the increase of Hp infection degree,serum ox-LDL level was increased（F = 16.143,P0.01） and SOD level was decreased（F = 55.686,P 0.01）.After treatment,serum ox-LDL level in treatment group was lower than that in control group（P0.01）,and SOD level was higher than that in control group（P 0.01）.The total effective rate of neural function recovery in treatment group was higher than that in control group（P0.01）.The recurrence rates of cerebral infarction in treatment group were lower than those in control group in half year and 1 year（P 0.05）.Conclusions Hp infection is an important risk factor for ACI.Active anti-Hp treatment can significantly reduce the oxidative stress reaction in patients with cerebral infarction,improve the efficiency of treatment,and reduce the recurrence rate of cerebral infarction in the short term.