幽门螺杆菌感染与短暂性脑缺血发作的关系

目的研究幽门螺杆菌(HP)感染与短暂性脑缺血发作(TIA)的关系,探讨抗Hp治疗对TIA患者预后的影响。方法选择发病后1w内住院的TIA患者(TIA组,n=84)和健康查体的离退休人员(对照组,n=78),检测血清HP抗体和C反应蛋白(CRP)水平。Hp阳性的TIA患者随机分为抗Hp治疗组(n=30)和常规治疗组(n=28)。抗Hp治疗组给予根除Hp治疗后随访1年,观察终点事件的发生,复查Hp抗体及CRP。结果 TIA组Hp感染率显著高于正常对照组(69.05%vs 51.28%,χ2=5.34,P<0.01)。TIA组CRP水平显著高于正常对照组(5.90±5.01 vs 1.37±0.89,t=8.17,P<0.01)。Hp阳性TIA患者CRP水平显著高于Hp阴性患者(7.37±6.00 vs 2.63±1.82,t=6.94,P<0.01)。抗Hp治疗后CRP显著降低(6.88±6.24 vs 2.81±2.39,t=3.34,P<0.01)。抗Hp治疗组TIA复发率显著低于对照组(3.33%vs 25%,χ2=4.04,P<0.05)。抗Hp治疗组急性脑梗死发生率显著低于对照组(0 vs 14.29%,χ2=4.60,P<0.05)。结论 Hp感染与TIA有关;CRP升高在Hp相关TIA发生中起一定作用;抗Hp治疗可显著降低TIA患者复发率,同时减少缺血性卒中的发生。

The relationship between helicobacter pylori infection and transient ischemia attack

Objective To study the correlation between helicobacter pylori （Hp） infection and transient isehemia attack （ TIA）.Methods HP antibodies and C reactive proteins （CRP） were determined in 84 patients with TIA and 78 individuals as controls. Hp positive TIA patients were randomly divided into two groups, one of which was treated to eradicate Hp （n = 30） , while the other was normal treated as a control group（ n = 28 ）. Results The positive rate for Hp-IgG in TIA patients was significantly higher than that of controls （69.05% vs 51.28%, x2= 5.34, P〈0.01）. The level of CRP in TIA patients was significantly higher than that of controls（5.90±5.01 vs 1.37±0.89, t= 8.17,P〈0.01 ）. The level of CRP in TIA patients with positive Hp-IgG was significantly higher than that in patients with negative Hp-IgG （ 7.37 ± 6.00 vs 2.63 ± 1.82, t = 6.94, P 〈 0.01 ） o The level of CRP was significantly reduced after the eradication of Hp（6.88±6.24 vs 2.81±2.39, t= 3.34,P〈0.01）. The recurrence rate of TIA in treated group was significantly lower than that of controls（ 3.33% vs 25%, x2= 4.04,P〈0.05）. The incidence rate of acute cerebral infarction in treated group was significantly lower than that of controls（ 0 vs 14.29%, x2= 4.60, P〈0.05） .Conclusions Hp infection is closely associated with transient ischemia attach. The eradication of Hp can effective improves the prognosis in patients with TIA.