摘要
目的探讨脑卒中高危人群幽门螺杆菌（Hp）感染与颈动脉粥样硬化（CAS）病变进展的关系，为脑卒中一级预防提供临床依据。方法连续性选取2014年6—12月皖北煤电集团总医院体检中心体检者2800人，收集其临床资料，筛选出脑卒中高危人群332例；选择其中颈动脉超声检查结果提示有斑块或狭窄者267例为研究对象，采用“C尿素呼气试验检测Hp感染情况，以符合筛选条件及完成随访的203例作为研究对象，动态观察颈动脉病变进展情况，分析颈动脉粥样硬化进展相关危险因素。结果2014年颈动脉超声提示颈动脉斑块和狭窄者267例，203例完成1年内随访，其中Hp感染者133例（65．5％，133／203）。2015年颈动脉狭窄及狭窄加重者46例，其中Hp感染者30例（65．2％，30／46）。Logistic回归分析显示，吸烟（OR=1．632，95％CI 1．275～1．940，P=0．011）、收缩压（OR=1．343，95％CI1．105～1．632，P=0．019）、低密度脂蛋白（OR=1．590，95％CI1．188—2．005，P=0．005）、氧化型低密度脂蛋白（OR=1．732，95％CI 1．325～2．170，P=0．000）、Hp感染（OR=1．672，95％CI 1．180—2．154，P=0．016）是CAS病变进展的危险因素。结论Hp感染与脑卒中高危人群CAS病变进展密切相关，积极有效地预防Hp感染、倡导戒烟、控制血压及血脂，能有效降低脑卒中的发生率。
Objective To investigate the relationship between Helicobacter pylori （Hp） infection and carotid atherosclerosis （CAS） progression in patients with high risk of stroke, and to provide clinical evidence for the primary prevention of stroke. Methods Three hundred and thirty-two patients with high risk of stroke were screened from 2 800 people who were consecutively selected and had health examination from June to December 2014 in the Department of Medical Center, General Hospital of Wanbei Coal and Electricity Group. Their clinical information was collected. A total of 267 patients whose carotid ultrasound examinations showed plaques and stenosis were selected for the study. Two hundred and three of the 267 patients who met the screening conditions and completed the follow-up were selected as study subjects. The Hp infection status was detected by the 14C urea breath test and the dynamic progression of CAS was observed. The risk factors of CAS progression were also analyzed. Results Hp infection was found in 170 of 332 patients with high risk of stroke. Among the 267 patients who prompted plaques and stenosis in carotid ultrasound in 2014, 203 patients were followed up for 1 year, and 133 patients （65.5% , 133/203 ） were found infected by Hp. Forty-six patients had suggestive carotid stenosis and stenosis aggravating in 2015, 31 （67.4%, 31/46） of which were found infected by Hp. Logistic regression analysis showed that smoking （ OR = 1. 632, 95% CI 1. 275 - 1. 940, P = 0. 011 ）, systolic blood pressure （ OR = 1. 343, 95% CI1.105- 1.632, P=0.019）, low density lipoprotein （OR= 1.590, 95% CI 1.188 -2.005, P=0. 005）, oxidative low density lipoprotein （ OR = 1. 732, 95% CI 1. 325 - 2. 170, P= 0. 000） and Hp infection （OR = 1. 672, 95% CI 1. 180 -2. 154, P=0. 016） were independent risk factors for earotid atheroslerosis progression. Conclusions Hp infection was found closely related to CAS progression in patients at high risk of stroke. Positive and effective prevention of Hp infection
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2016年第10期780-784,共5页
Chinese Journal of Neurology
