急性脑梗死患者血清同型半胱氨酸、肿瘤坏死因子-α变化与幽门螺杆菌感染的相关性

Changes of serum homocysteine and tumor necrosis factor alpha levels in patients with acute cerebral infarction and their relationship to Helicobacter pylori infection

目的探讨急性脑梗死患者血清同型半胱氨酸(homocysteine,Hcy)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)变化与幽门螺杆菌(helicobacter pylori,Hp)感染的相关性。方法选取2013年8月—2016年9月唐山市迁西县人民医院收治的急性脑梗死患者100例作为研究组,另选取同期健康体检者36例为对照组,检测2组血清Hcy、TNF-α、超敏C反应蛋白、Hp-IgG抗体及血脂水平,并进行14C尿素呼气试验和快速尿素酶试验。结果研究组中Hp感染患者72例(72.00%)、非Hp感染者28例(28.00%),对照组Hp感染者16例(44.44%),2组Hp感染率差异有统计学意义(P<0.05);Hp感染者血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇、Hcy、TNF-α及超敏C反应蛋白水平均较非Hp感染者高(P<0.05);而高密度脂蛋白胆固醇水平则是非Hp感染者高于Hp感染者(P<0.05)。急性脑梗死患者血清Hcy和TNF-α与Hp感染呈正相关(r=0.322、P<0.05,r=0.231、P<0.05)。结论急性脑梗死患者血清Hcy和TNF-α与Hp感染相关,血清Hcy和TNF-α及Hp感染与急性脑梗死病情的进展情况有关,清除Hp感染可能成为一种临床治疗急性脑梗死的策略。

Objective To investigate the relationship between the changes of serum homocysteine( Hcy) and tumor necrosis factor-alpha( TNF-α) in helicobacter pylori( Hp) with acute cerebral infarction. Methods One hundred patients with acute cerebral infarction who were admitted to our hospital from August 2013 to September 2016 were selected as the study group,and the other 36 healthy subjects were selected as control group.The serum levels of Hcy,TNF-a,high-sensitive C-reactive protein( hs-CRP),Helicobacter pylori immunoglobulin G( Hp-IgG) antibody and lipid levels were measured in two groups,and14 C urea breath test(14C-UBT),rapid urease test( RUT) were performed. Results In the study group,72 cases were Hp infection( 72. 00%),28 were non-Hp infected patients( 28. 00%). In the control group,Hp infections were 16 cases( 44. 44%),the Hp infection rate of the two groups was statistically significant( P<0. 05). The serum total cholesterol( TC),triacylglycerol( TG),low density lipoprotein cholesterol( LDL-C),homocysteine( Hcy),TNF-α and hs-CRP levels were higher in Hp infection group than those in nonHp infection group( P<0. 05),while the level of HDL-C in non-Hp infection group was higher than in Hp group,the difference was statistically significant( P <0. 05). The levels Hcy,and TNF-α of in patients with acute cerebral infarction were positively related to Hp infection( r = 0. 322,P <0. 05; r = 0. 231,P<0. 05). Conclusion The patients with acute cerebral infarction are related to levels of serum Hcy,TNF-α and Hp infection. Serum Hcy and TNF-α and Hp infection result in disease progression,which suggest that the clearance of Hp infection may become a clinical strategy for the treatment of acute cerebral infarction.