幽门螺杆菌感染与不同类型脑梗死患者C-反应蛋白的关系研究

Study on the relationship of helicobacter pylori infection and C-reactive protein with cerebral infarction

目的研究幽门螺杆菌(Hp)感染与不同类型脑梗死(CI)患者的关系,及Hp-CagA-IgG抗体浓度与血清C-反应蛋白(CRP)水平的关系,探讨Hp感染影响CI患者发病的可能机制。方法通过生物蛋白芯片技术检测Hp-CagA-IgG抗体来评价Hp感染对不同类型CI患者的影响;应用免疫比浊法测定血清CRP水平,观察Hp感染与血清CRP的关系。结果 (1)急性脑梗死(ACI)患者组Hp-CagA-IgG抗体阳性率及抗体浓度较对照组显著升高(P<0.05)。其中,动脉粥样硬化性脑梗死组的Hp-CagA-IgG抗体阳性率、抗体浓度高于对照组(P<0.05),而腔隙性脑梗死组与对照组间(P>0.05);(2)动脉粥样硬化性脑梗死患者组的CRP水平高于对照组(P<0.05),且Hp-CagA-IgG抗体浓度与血清CRP浓度呈正相关(r=0.427,P<0.001)。结论 CagA阳性菌株Hp感染与脑梗死发病存在相关性,且与大动脉粥样硬化性脑梗死关系更为密切,其机制可能是通过直接作用血管内皮及介导全身炎症反应,促使动脉粥样硬化,导致动脉粥样硬化性脑梗死的发生,从而为根除Hp感染预防脑梗死的临床应用提供了实验依据。

Objective To observe the relationship of helicobacter pylori（Hp）infection and different types of acute cerebral infarction（ACI）, and investigate the possible pathogenic mechanisms of Hp infection on cerebral infarction（CI）. Method We detected the cytotoxin-associated protein A（CagA） antibody（Hp-CagA-IgG） through the biological protein chip technique to evaluate the effect of Hp infection on different types of CI. And we measured the levels of serum C-reactive protein（CRP） by means of immuno-nephelometry to observe the relationship between CRP and Hp infection. Results（1） The positive rateof Hp-CagA-IgG was obviously higher in CI group than controls group（P〈0.05）. In the different types of CI, the positive rate of Hp-CagA-IgG with its concentration and CRP concentration in atherothrombotic cerebral infarction group were all increased compared with controls group（P〈0.05）, but there was no significant difference between lacunar infarction and controls group（P〈0.05）;（2） The concentration of Hp-CagA-IgG was linear positive correlated with CRP（r=0.427, P〈0.001）. Conclusion Hp infection is relative with ACI and is closer with atherothrombotic CI. And the potential pathogen is possible by mediating the systemic and local inflammatory response to initiate and accelerate the formation of atherosclerosis and plaque, providing evidence for the eradication of Hp to prevent from CI.