HP感染对脑梗死患者凝血功能的影响

目的 观察HP感染对脑梗死患者凝血功能的影响,探讨其参与脑梗死发病的机制,提供临床预防脑梗死发生的新思路.方法 185例动脉粥样硬化性血栓性脑梗死患者,根据幽门螺旋杆菌（HP）IgG抗体蛋白生物微矩阵（芯片）分析系统测定的患者HP抗体情况分为两组,并对比观察两组间凝血功能的不同.结果 非HP感染患者69例（37.3%）,HP感染患者116 例（62.7%）,其中CagA＋24例,VacA＋36例,CagA＋ VacA＋34例,CagA- VacA-22例;HP感染组患者平均年龄及合并有高脂血症的患者比例较非HP感染患者明显增加（P＜0.05）;HP感染组患者PT、PTR、INR较非HP感染组无明显差异（P＞ 0.05）,而APTT、TT、FIB三个指标变化明显（P＜0.05）,其中APTT、TT缩短,FIB含量增加,尤以CagA＋患者改变明显.结论 HP感染严重影响脑梗死凝血功能,参与动脉粥样硬化性血栓性脑梗死的发生,提示早期根治HP感染及尽早应用抗凝、降纤治疗,有可能减少脑梗死的发病.

The Effect of HP on Coagulation Function in Patients with Cerebral Infarction

Objective To observe the effect of HP infection on coagulation function in patients with cerebral infarction,and to explore the mechanism of their participation in cerebral infarction,and provide new ideas of clinical prevention of Cerebral infarction.Method 185 patients with atherosclerotic thrombotic cerebral infarction,according the HP-antibodies by Helicobacter pylori（HP） IgG antibody biological microarray（chip） analysis system,were divided into two groups,and observed the difference of coagulation in two groups.Result HP infected patients were 116（62.7%）,of which CagA- patients were 24,VacA＋ patients 36,CagA- VacA＋ patients 34, CagA VacA patients 22.The average age and proportion of patients combined with hyperlipidemia in HP-infected group increased significantly（P 〈 0.05） than non- HP-infected patients;the change of PT, PTR, INR in HP-infected was not significant（P 〉 0.05） compared with non-HP infection group,but APTT, TT, FIB changed significantly（P 〈 0.05）,in which APTT, TT shortening,FIB increasing, especially CagA＋ patients changed most significantly. Conclusion HP infection affected severely blood coagulation in patients with cerebral infarction,involved in occurrence of atherosclerotic thrombotic cerebral infarction,and suggested that it is possible to reduce the incidence of cerebral infarction by the cure of HP infection,anticoagulation and defibrase treatment in early.