| 幽门螺杆菌感染与急性缺血性脑卒中不良预后关系的队列研究 |
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| 引用本文： | 高雅, 黄萍, 张培培, 国钰梅, 吕利英, 周蓦, 龙振海, 张永红, 许锬. 幽门螺杆菌感染与急性缺血性脑卒中不良预后关系的队列研究[J]. 中华疾病控制杂志, 2018, 22(8): 766-771. doi: 10.16462/j.cnki.zhjbkz.2018.08.002 |
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| 作者姓名： | 高雅 黄萍 张培培 国钰梅 吕利英 周蓦 龙振海 张永红 许锬 |
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| 作者单位： | 1. 苏州大学医学部公共卫生学院流行病与卫生统计学系, 江苏 苏州 215123;;;2. 常州市中医医院病案室, 江苏 常州 213000;;;3. 常州市疾病预防控制中心急性传染病防制所, 江苏 常州 213000;;;4. 内蒙古兴安盟人民医院检验科, 内蒙古 兴安盟 137400;;;5. 苏州市立医院科教科, 江苏 苏州 215123;;;6. 辽宁省阜新市中心医院神经科, 辽宁 阜新 123000 |
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| 基金项目： | 国家自然科学基金（81172760） |
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| 摘 要： | 目的 探讨幽门螺杆菌（helicobacter pylori，HP）感染与急性缺血性脑卒中（acute ischemic stroke，AIS）不良预后的关系。方法 于2011年6月~2013年12月在中国7省14家医院纳入AIS首发病人，建立研究队列。在患者入院24 h内采集静脉血样本，检验HP-IgG含量，并在发病后1年时进行随访，调查和收集不良预后信息。采用Cox回归模型分析HP-IgG水平和AIS不良预后的关系。结果 共纳入AIS患者1 150人，HP-IgG M（P25，P75）为10.14（7.39，15.05）ng/L。患者病后至1年时死亡、心血管事件、心血管死亡以及死亡或心血管事件发生率分别为4.83%、7.90%、3.72%和11.43%。应用Cox回归模型调整多因素后，以G1为比较组，G4组发生死亡和心血管死亡的风险升高，HR（95%CI）值分别为3.43（1.26~9.36）和5.45（1.57~18.90）；G2组、G3组、G4组发生死亡或心血管事件的风险升高，HR（95%CI）值分别为1.84（1.02~3.34）、2.00（1.12~3.56）和1.97（1.10~3.55）；且随着HP-IgG水平升高，发生死亡、心血管死亡以及死亡或心血管事件的风险升高（均有P<0.05）。结论 HP感染是AIS不良预后的危险因素，高水平的HP-IgG能增加AIS发病1年后死亡、心血管死亡以及死亡或心血管事件的发生风险。
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| 关 键 词： | 幽门螺杆菌 急性缺血性脑卒中 预后 队列研究 |
| 收稿时间： | 2017-12-12 |
| 修稿时间： | 2018-05-21 |
The relationship between helicobacter pylori infection and adverse prognosis of acute ischemic stroke: a cohort study |
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| GAO Ya, HUANG Ping, ZHANG Pei-pei, GUO Yu-mei, LÜ Li-ying, ZHOU Mo, LONG Zhen-hai, ZHANG Yong-hong, XU Tan. The relationship between helicobacter pylori infection and adverse prognosis of acute ischemic stroke: a cohort study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2018, 22(8): 766-771. doi: 10.16462/j.cnki.zhjbkz.2018.08.002 |
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| Authors: | GAO Ya HUANG Ping ZHANG Pei-pei GUO Yu-mei LÜ Li-ying ZHOU Mo LONG Zhen-hai ZHANG Yong-hong XU Tan |
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| Affiliation: | 1. Department of Epidemiology and Health Statistics, School of Public Health, Medical College of Soochow University, Suzhou 215123, China;;;2. Department of Medical Record, Changzhou Chinese Medicine Hospital, Changzhou 213000, China;;;3. Institute of Acute Infectious Disease Control and Prevntion, Changzhou Center for Disease Control and Prevention, Changzhou 213000, China;;;4. Clinical Laboratory, People's Hospital of Xing'an meng, Xing'an meng 137400, China;;;5. Department of Science and Education, Suzhou Municipal Hospital, Suzhou 215123, China;;;6. Department of Neurology, Fuxin Central Hospital, Fuxin 123000, China |
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| Abstract: | Objective To examine the association between helicobacter pylori (HP) infection and the adverse prognosis at 1 year after onset of acute ischemic stroke (AIS).Methods From June 2011 to December 2013, first onset cases of AIS were collected from 14 hospitals in 7 provinces of China to establish research cohort. The venous blood sample of patients was taken to do HP-IgG content test within 24 hours after admission. The follow-up was conducted at 1 year after the onset of AIS, and the adverse prognosis outcome information was investigated and collected. Cox regression models were applied to estimate the association between different quartile levels of HP-IgG and different prognosis outcomes. Results A total of 1 150 AIS cases was conducted in the study. The M(P25,P75) of venous HP-IgG was 10.14(7.39,15.05) ng/L. Within 1 year after AIS onset, the incidence of all-cause death, cardiovascular events cardiovascular death and death or cardiovascular events was 4.83%, 7.90%, 3.72%and 11.43%, respectively. After adjustment for multiple factors, Cox regression model showed that the risk of all-cause mortality and cardiovascular death increased in G4 group compared to the G1 group, and the HR(95% CI) was 3.43(1.26-9.36) and 5.45(1.57-18.90), respectively; The risk of death or cardiovascular events increased in G2, G3 and G4 group compared to G1 group, and the HR(95% CI) was 1.84(1.02-3.34), 2.00(1.12-3.56) and 1.97(1.10-3.55), respectively; the 1 year risks of mortality and death or cardiovascular events were both increased with the level elevated in quartile groups, and the test of tendency was statistically significant (all P<0.05). Conclusions HP infection is the risk factor of AIS adverse prognosis. High HP-IgG level can increase the risk of mortality, cardiovascular death and death or cardiovascular event within 1 year after AIS onset. |
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| Keywords: | Helicobacter pylori Acute ischemic stroke Prognosis Cohort study |
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