缺血性脑卒中亚型与幽门螺杆菌感染相关性研究

A study of the correlation between subtypes of ischemic stroke and Helicobacter pylori infection

目的分析缺血性脑卒中亚型与幽门螺杆菌感染相关性,为该病的临床治疗提供指导。方法回顾性分析2016年1-10月期间在本院住院的179例缺血性脑卒中患者(病例组)和同时期193例健康体检者(对照组)幽门螺杆菌感染情况;采用CISS脑卒中分型方法对病例组进行缺血性脑卒中分型,分析缺血性卒中亚型与幽门螺杆菌感染的相关性。结果分析人口统计学特征及临床资料,病例组和对照组患者高血压病史、糖尿病史、吸烟史、家族卒中病史对比的OR值>1,性别、生活规律、消化性溃疡病史、高脂血症、教育程度对比的OR值<1。病例组幽门螺杆菌感染127例,感染率为70.95%;对照组幽门螺杆菌感染109例,感染率为56.48%。幽门螺杆菌感染可能是缺血性脑卒中患者发病的危险因素(OR值为1.88,95%CI值为1.22~2.89)。采用CISS分型法对缺血性脑卒中进行分型,主要类型为LAA、CS、PAD、OE和UE。其中3种主要亚型LAA型感染90例,感染率为70.87%,OR值为1.65;CS型感染25例,感染率为19.69%,OR值为0.91;PAD感染12例,感染率为9.45%,OR值为0.44。幽门螺杆菌感染可能是LAA型缺血性脑卒中发生的危险因素。结论高血压病史、糖尿病史、吸烟史、家族卒中病史可能增加发生缺血性脑卒中的风险,幽门螺杆菌感染可能是LAA型缺血性脑卒中发生的危险因素。

Objective To analyze the correlation between subtypes of isehemic stroke and H. pylori infection in order to guide effective clinical treatment. Methods The H. pylori infection status of 179 patients who had suffered an is- chemic stroke （the patient group） and 193 individuals who underwent a health examination during the same period （the control group） at this Hospital from January to October 2016 was retrospectively analyzed. In the patient group, the is- chemic stroke suffered was classified using the Chinese Isehemic Stroke Subelassification （CISS）. The correlation between subtypes of ischemic stroke and H. pylori infection was analyzed. Results An analysis of demographic characteristics and clinical data revealed that a history of hypertension, a history of diabetes, a history of smoking, and a family history of stroke all had an OR greater than 1 in both the patient group and the control group, but gender, a regular lifestyle, a history of peptic ulcer disease, hyperlipemia, and level of education all had an OR less than 1 in both the patient group and the control group. One hundred and twenty-seven patients in the patient group were infected with H. pylori, for an in- fection rate of 70.95 %. One hundred and nine individuals in the control group were infected with H. pylori, for an infec- tion rate of 56. 48%. H. pylori infection may be a risk factor for illness in patients who had suffered an ischemie stroke （OR = 1.88 and 95%CI = 1.22--2.89）. According to the CISS, the etiology of an ischemic stroke was mainly catego- rized as large artery atherosclerosis （LAA）, cardiogenic stroke （CS）, penetrating artery disease （PAD）, some other eti ology （OE）, and an undetermined etiology （UE）. Ninety patients who suffered a stroke due to LAA were infected with H. pylori, for a rate of infection of 70.87%0 ; the OR for a stoke due to LAA was 1.65. Twenty-five patients who suf- fered a CS were infected with H. pylori, for a rate of infection of 19.69% ; the OR for a CS was 0.91. Twelve patients who suffered a stroke due to PAD were infected with H. pylori, for a rate of infection of 9.45 % ; the OR for a stoke due to PAD was 0.44. Thus, H. pylori infection may be a risk factor for patients who suffered an ischemic stroke due to LAA. Conclusion A history of hypertension, a history of diabetes, a history of smoking, and a family history of stroke may increase the risk of illness in patients who had suffered an ischemic stroke. H. pylori infection may be a risk factorfor patients who had suffered all ischemic stroke due to LAA.