伴幽门螺杆菌感染脑梗死患者临床特征及预后分析

Clinical Characteristics and Prognosis of Cerebral Infarction Patients Complicated with Infection of Helicobacter Pylori

目的探讨伴幽门螺杆菌(helicobacter pylori, Hp)感染脑梗死患者临床特征及预后情况。方法选取脑梗死96例作为研究对象,其中Hp感染42例,非Hp感染54例,回顾性分析其临床及随访资料,比较Hp感染和非Hp感染脑梗死患者临床特征、预后情况,并对影响脑梗死患者生存情况的相关因素进行分析。结果 Hp感染脑梗死42例占同期脑梗死43.75%(42/96)。Hp感染脑梗死患者较非Hp感染脑梗死患者血C反应蛋白(CRP)水平更高,颈动脉狭窄和颈动脉粥样硬化程度更严重,差异有统计学意义(P<0.05)。随访结束后,Hp感染脑梗死患者复发率和病死率均显著高于非Hp感染脑梗死患者,二者比较差异具有统计学意义(P<0.05)。Log Rank检验单因素分析结果显示,不同血CRP水平、不同程度颈动脉狭窄和颈动脉粥样硬化以及是否合并Hp感染脑梗死患者生存率比较差异具有统计学意义(P<0.05)。多元Cox逐步回归分析结果显示,血CRP水平过高,重度颈动脉狭窄和颈动脉粥样硬化以及Hp感染均为影响脑梗死患者预后的独立危险因素(P<0.05)。结论伴Hp感染脑梗死患者血CRP水平较高、颈动脉狭窄和硬化程度较为严重,且CRP水平过高、重度颈动脉狭窄和颈动脉粥样硬化程度以及Hp感染均为影响脑梗死患者预后的独立危险因素。

Objective To investigate the clinical characteristics and prognosis of patients with cerebral infarction(CI) complicated with infection of Helicobacter pylori(Hp). Methods Ninety-six patients with CI were selected as the study subjects, including 42 patients with Hp infection and 54 patients without HP infection. The clinical and follow-up data were retrospectively analyzed, and the clinical characteristics and prognosis between patients with CI complicated with Hp infection and those without HP infection were compared. The factors affecting the survival of patients with CI were analyzed. Results Forty-two patients with CI complicated with Hp infection accounted for 43.75%(42/96) of CI. However, the level of C-reactive protein(CRP) in patients with CI complicated with Hp infection was higher than that in CI patients without HP infection. The stenosis of carotid artery and carotid atherosclerosis were more severe, and the difference was statistically significant(P<0.05). After follow-up, the recurrence rate and mortality rate of CI patients complicated with Hp infection were significantly higher than those of CI patients without Hp infection, and the difference was statistically significant(P<0.05). Univariate analysis(Log Rank test) showed that there were significant differences in the survival rate of CI patients with different CRP levels, different degrees of carotid artery stenosis and carotid atherosclerosis, and with or without Hp infection(P<0.05). Multivariate Cox stepwise regression analysis showed that excessively high serum CRP levels, excessively severe carotid stenosis and atherosclerosis, and Hp infection were the independent risk factors affecting the prognosis of patients with CI(P<0.05). Conclusion Patients with CI complicated with Hp infection had a higher level of serum CRP, and extremely severe carotid stenosis and atherosclerosis, which, along with Hp infection, were independent risk factors affecting the prognosis of CI patients.