缺血性脑卒中患者幽门螺杆菌感染与同型半胱氨酸关系探讨

目的 探讨缺血性脑卒中患者幽门螺杆菌(Hp)感染与血脂、血清同型半胱氨酸(Hcy)水平变化的相关性.方法 选择2011年1-6月医院收治的缺血性脑卒中患者48例为研究对象,另选择40例健康体检者为对照组；采用酶联免疫吸附法(ELISA)和循环酶法检测HpIgG及Hcy表达水平,并检测血脂,分析Hp感染与血脂、血清Hcy表达之间的关系.结果 缺血性脑卒中组患者HpIgG阳性率为77.08％、血清总胆固醇(TC)为(5.36±0.68)mmol/L、甘油三酯(TG)为(1.95±0.49)mmol/L、低密度脂蛋白胆固醇(LDL-C)为(3.16±0.68)及Hcy(20.84±6.73)μmol/L的表达水平均明显高于对照组的HpIgG阳性率32.50％、TC为(4.12±0.45)mmol/L、TG为(1.15±0.39)mmol/L、LDL-C为(2.21±0.64)mmol/L、Hcy为(11.65±5.96) μmol/L;而缺血性脑卒中患者的高密度脂蛋白胆固醇(HDL-C)为(1.02±0.29)mmol/L表达水平明显低于对照组的(1.28±0.26) mmol/L；Hp感染阳性缺血性脑卒中患者的血清TC(5.79±0.94) mmol/L、TG(2.09±0.62) mmol/L、LDL-C( 3.46±0.72)mmol/L及Hcy(24.65±6.48)μmol/L表达水平均明显高于Hp感染阴性患者的(4.85±0.69)mmol/L、(1.53±0.34)mmol/L、(2.84±0.81 )mmol/L、(15.49±5.63) μmol/L;而HDL-C(0.88±0.19)mmol/L表达水平显著低于Hp感染阴性患者的(1.12±0.28)mmol/L,差异均有统计学意义(P＜0.05).结论 Hp感染与缺血性脑卒中发生有相关性,可能通过对血脂代谢及血清Hcy表达水平的影响,而促进缺血性脑卒中的发生发展.

Study on relationship between Helicobacter pylori infections and blood-lipoids,serum homocysteine in acute ischemic stroke patients

OBJECTIVE To explore the relationship between Helicobacter pylori infections and blood-lipoids,homocysteine(Hcy) in acute ischemic stroke.METHODS A total of 48 patients with acute ischemic stroke were selected as stroke group and 40 health people as control group.Serum specific antibodies to Hp(Hp IgG) were measured in control group and stroke group by the ELISA.The level of serum Hcy was measured in two groups by enzymatic cycling method.The relationship between Hp infection and the expression of serum Hcy and blood-lipoids was analyzed.RESULTS The positive rate of Hp IgG(77.08%) and the expression of serum TC(36±0.68 mmol/L,TG(1.95±0.49 mmol/L),LDL-C(3.16±0.68 mmol/L) and Hcy(20.84±6.73μmol/L) in the stroke group were respectively higher than those in the control group(32.50%,4.12±0.45mmol/L,1.15±0.39 mmol/L,2.21±0.64mmol/L,11.65±5.96μmol/L);the expression of serum HDL-C(1.02±0.29 mmol/L)in stroke group was lower than that in control group(1.28±0.26mmol/L);those who were Hp IgG positive had significant higher levels of TC(5.79±0.94 mmol/L),TG(2.09±0.62 mmol/L),LDL-C(3.46±0.72 mmol/L) and Hcy(24.65±6.48μmol/L) than did those who were Hp IgG negative(4.85±0.69mmol/L,1.53±0.34mmol/L,2.84±0.81mmol/L 15.49±5.63μmol/L);those who were Hp IgG positive had significant lower levels of HDL-C(0.88±0.19 mmol/L)than did those who were Hp IgG negative(1.12±0.28mmol/L),the differences were statistically significant(all P<0.05).CONCLUSION There is significant correlation between Hp infection and acute ischemic stroke.Hp infection may involve in the pathogenesis of acute ischemic stroke by increasing the expression of blood-lipoids and Hcy.