幽门螺杆菌感染与脑梗死复发的关系及其机制研究

Study on the relationship between Helicobacter pylori infection and recurrence of cerebral infarction and its mechanism

目的探讨幽门螺杆菌(HP)感染与脑梗死复发的相关性及其作用机制,为抗HP治疗降低脑梗死复发率提供依据。方法对我院神经内科收治的600例初发脑梗死患者,采用碳14呼气试验来定性HP感染患者,其中HP阴性患者197例为对照组(A组),HP阳性患者403例中,203例行标准三联疗法的患者为HP阳性治疗组(B组),200例未行抗HP治疗的患者为HP阳性观察组(C组)。所有患者均采用免疫投射比浊法定量血清超敏C反应蛋白(CRP),采用荧光偏振免疫测定法定量同型半胱氨酸(HCY),并进行为期3年的随访,比较3组患者的脑梗死复发率和CRP、HCY水平。结果 3组患者中,在随访期间复发率为HP阳性观察组为38.77%,HP阳性治疗组为25.37%,HP阴性对照组为20.51%。结论 HP感染与脑梗死有相关性,可通过作用于CRP和HCY加重动脉硬化,而增加脑梗死复发率。

Objective To investigate the correlation between Helicobacter pylori （HP） infection and recurrence of cerebral infarction and its mechanism of action,so as to provide evidence for anti HP therapy and reducing the recurrence rate of cerebral infarction.Methods The Department of Neurology of our hospital 600 cases of primary cerebral infarction patients,using carbon 14 breath test to determine the nature of HP infection in patients with HP negative patients 197 cases as control group （A）,403 cases of HP positive patients,203 patients underwent standard triple therapy patients were positive for HP treatment group （B）,200 cases without anti HP treated patients were positive for HP observation group （C）.All patients were treated with immune turbidimetry quantitative serum high-sensitivity C reactive protein （CRP）,by fluorescence polarization immunoassay quantitative homocysteine （HCY）,and for a period of 3 years of follow-up,the recurrence rate of patients with cerebral infarction and CRP,HCY levels between the 3 groups.Results In the 3 groups,the recurrence rate was in the follow-up group,38.77% in the HP positive observation group,25.37% in the HP positive treatment group and 20.51% in the HP negative control group.Conclusion HP infection is associated with cerebral infarction.It can increase the recurrence rate of cerebral infarction by increasing the arteriosclerosis by CRP and HCY.