Relationship and mechanisms for the recurrence of cerebral infarction with Helicobacter pylori infection
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摘要: 目的 脑梗死患者幽门螺杆菌(HP)感染率增加,HP感染可能是脑梗死发生的危险因素之一,但HP感染与脑梗死复发的相关性目前仍不明确。为了探讨HP感染与脑梗死复发的相关性及可能机制,本文对比分析了HP阳性与阴性脑梗死患者的复发率及血清超敏C反应蛋白(CRP)、同型半胱氨酸(HCY)水平。 方法 解放军第四五七医院2009年1月—2012年3月收治的初发脑梗死患者624例中,HP阳性者298例为HP阳性组,HP阴性者326例为HP阴性组。对2组患者进行为期3年的随访,比较2组患者脑梗死复发率,采用放射免疫法检测2组患者血清超敏C反应蛋白水平,免疫比浊法检测血清同型半胱氨酸水平。对HP阳性患者采用标准“四联”疗法抗HP治疗,比较126例HP转阴患者与未转阴患者脑梗死复发率及CRP、HCY水平。 结果 随访患者中3年内脑梗死复发HP阳性组(29.4%)显著高于HP阴性组(19.6%),χ2=7.833,P=0.005。HP阳性患者中根除HP后脑梗死复发率(20.8%)较未根除患者(35.5%)显著降低(χ2=7.264,P=0.007)。血清CRP及HCY水平在HP阳性组[(8.12±2.86) mg/L,(16.86±6.83) μmol/L)]均分别显著高于HP阴性组[(6.82±2.18) mg/L,(14.76±6.21) μmol/L](P<0.01);HP阳性组根除HP后CRP(7.23±2.16) mg/L及HCY水平(15.22±5.68) μmol/L较未根除者[(8.64±3.26) mg/L,(17.32±7.38) μmol/L]显著降低(P<0.01)。 结论 HP感染可能通过提高血清CRP及HCY水平,从而增加脑梗死复发的几率。Abstract: Objective To explore the relationship between the HP infection and the recurrence of cerebral infarction and the possible mechanisms. Methods HP was tested among 624 primary cerebral infarction patients in our hospital from January 2009 to March 2012,298 cases with positive result were assigned into HP positive group,and 326 cases with negative result into HP negative group.ALL patients were followed for 3 years.The recurrence rate of cerebral infarction was compared between the two groups.The serum levels of CRP were detected by radio-immunity methods and the levels of homocysteine(HCY) were detected by immunoturbidimetry methods.After the standard “quadruple chemotherapy” for HP,the recurrence rate of cerebral infarction,and levels of CRP and HCY were compared between 126 cases turned back negative and other patients. Results The recurrence of cerebral infarction was higher in HP positive group(29.4%) than HP negative group(19.6%) (χ2=7.833,P=0.005).After the eradication of HP,the recurrence of cerebral infarction was decreased as compared with non-eradication of HP(20.8% vs. 35.5%),χ2=7.264,P=0.007.The levels of CRP and HCY were increased in HP positive group[(8.12±2.86) mg/L,(16.86±6.83) μmol/L)] when compared with HP negative group[(6.82±2.18) mg/L,(14.76±6.21) μmol/L](P<0.01),and were decreased after the eradication of HP[(7.23±2.16) mg/L,(15.22±5.68) μmol/L] as compared with non-eradication of HP[(8.64±3.26) mg/L,(17.32±7.38) μmol/L](P<0.01). Conclusion The HP infection is related to the recurrence of cerebral infarction by increasing the levels of CRP and HCY.
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Key words:
- Cerebral infarction /
- Recurrence /
- Helicobacter pylori /
- C-reactive protein /
- Homocysteine
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