幽门螺杆菌对患者缺血性卒中复发与血流动力学的影响  

Influence of Helicobacter pylori on recurrence of ischemic stroke and hemodynamics

作　　者：张舒校[1] 牛延良[1] 贺刚锐[1] 王利军[1] 田志强[1] 

机构地区：[1]郑州大学第五附属医院神经内科,河南郑州450030

出　　处：《中华医院感染学杂志》2017年第13期2935-2938,共4页Chinese Journal of Nosocomiology

摘　　要：目的探究幽门螺杆菌(Hp)感染对缺血性卒中复发以及血流动力学的影响。方法选取2011年1月-2013年1月于医院接受治疗的146例缺血性卒中患者为研究对象,对患者进行13 C尿素呼气试验并根据检验结果将患者分为两组,其中58例发生Hp感染的患者为观察组,88例未发生感染的患者为对照组;比较两组患者总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、超敏C-反应蛋白(hs-CRP)、纤维蛋白原(Fg)等指标含量;治疗2周后比较两组患者缺血性卒中临床疗效;比较两组患者颈动脉狭窄和颈动脉粥样硬化分布情况;检测患者大脑前动脉(ACA)、双侧大脑中动脉(MCA)、大脑后动脉(PCA)和颈内动脉末端(TICA)的血流平均流速(Vm)、平均血流量(Qm)、脉动指数(PI);所有患者出院后进行为期3年的随访,比较两组患者出院后1年、2年、3年复发率及死亡率。结果两组患者血脂指标、炎症因子以及Hp抗体比较,差异有统计学意义(P<0.05);观察组治疗有效率为67.2%,对照组为84.1%,两组比较差异有统计学意义(P<0.05);观察组颈动脉狭窄和颈动脉粥样硬化高于对照组,两组比较差异有统计学意义(P<0.05);观察组与对照组不同动脉血流平均速度、平均血流量比较,差异有统计学意义(P<0.05),且两组患者特性阻抗(Zc)与动态阻力(DR)比较,差异有统计学意义(P<0.05);观察组出院3年后复发率与死亡率高于对照组,差异有统计学意义(P<0.05)。结论 Hp感染不利于缺血性卒中患者临床治疗疗效的提高,对患者血流动力学有不利影响,患者出院后复发率与死亡率较高,临床应对此类患者进行加强控制以提高生存质量。OBJECTIVE To explore the influence of Helicobacter pylori infection on recurrence of ischemic stroke and hemodynamics.METHODS A total of 146 patients with ischemic stroke who were treated in the hospital from Jan 2011 to Jan 2013 were recruited as the study objects and were divided into two groups on basis of result of 13 C urea breath test,58 patients who had H.pylori infection were assigned as the observation group,and 88 patients who did not have the infection were set as the control group.The levels of total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein（HDL-C）,low-density lipoprotein（LDL-C）,high-sensitivity C-reactive protein（hs-CRP）,and fibrinogen（Fg）were compared between the two groups of patients,the clinical effect was compared between the two groups of ischemic stroke patients after the treatment for 2 weeks;the distribution of carotid artery stenosis and carotid atherosclerosis was compared between the two groups of patients;the mean blood flow velocity（Vm）,mean blood flow（Qm）and pulsatility indexes（PI）of anterior cerebral artery（ACA）,posterior cerebral artery（PCA）,and terminal internal carotid artery（TICA）were determined;a three-year follow-up was conducted for all of the patients after they were discharged;the recurrence rate and mortality rate were compared between the two groups of patients after the discharge for 1,2,and 3 years.RESULTS There was significant difference in serum lipid parameters,inflammatory factors,or Hp antibody between the two groups of patients（P〈0.05）.The effective rate of treatment was 67.2% in the observation group,84.1% in the control group,and there was significant difference between the two groups（P〈0.05）.The incidence of carotid artery stenosis and carotid atherosclerosis was significantly higher in the observation group than in the control group（P〈0.05）.There was significant difference in the mean blood flow velocity or mean blood flow volume of the arteries between the observation group and th

关 键 词：HP感染 缺血性卒中 卒中进展 血流动力学 

分 类 号：R378[医药卫生—病原生物学]