单纯疱疹病毒2型感染与缺血性脑卒中不良预后的关系

目的 探讨单纯疱疹病毒2型（herpes simplex virus 2，HSV-2）感染与缺血性脑卒中发病后14 d（或出院）时不良预后的关系。方法 2011年6月~2013年12月，本研究采用队列研究的方法，从国内14家医院纳入确诊的缺血性脑卒中病例1 150例，检测入院时血清HSV-2 IgG水平，以发病后14 d（或出院）发生死亡或心血管事件为不良预后，采用Logistic回归方法分析HSV-2 IgG水平与不良预后的关系。结果 依HSV-2 IgG四分位数将病例分为4组，以第1分位组为参照组，经多因素调整后第4分位组发生不良预后的风险是参照组的4.32倍（95% CI：1.33~14.03，P=0.015），且随不同组间HSV-2 IgG水平的增加，不良预后的发生风险有增加的趋势。亚组分析发现，病例为女性、或不饮酒、或伴有糖尿病、或伴有高血压时，高水平HSV-2 IgG可增加14 d（或出院）时不良预后的发生风险（均有P<0.05）。结论 缺血性脑卒中伴HSV-2感染时，高水平的HSV-2 IgG能增加病后14 d（或出院）时不良预后的发生风险，且随HSV-2 IgG水平的增加，不良预后的发生风险有增加的趋势。

Herpes simplex virus 2 infection is associated with adverse prognosis for ischemic stroke

Objective To examine the association between herpes simplex virus type 2 (HSV-2) infection and the adverse prognosis at 14 days (or discharge) after onset of ischemic stroke.Methods A cohort study of 1150 ischemic stroke cases was conducted,who were from 14 hospitals with confirmed diagnosis and blood HSV-2 IgG tested.Adverse prognosis was defined with death or onset of cardiovascular events after 14 days (or discharge).Logistic regression was applied to estimate the association between HSV-2 and adverse prognosis.Results HSV-2 IgG was classified with quartile.First quartile was used with reference,after multiple factors adjusted,fourth quartile was 4.32-fold risk to first quartile (P =0.015),the risk was increased with the level elevated in quartile groups.Subgroup analysis showed that elevated HSV-2 IgG increased the risk of adverse prognosis among cases in female,or non-drinking,or with diabetes,or with hypertension (all P ＜ 0.05).Conclusions In ischemic stroke with HSV-2 infection,elevated HSV-2 IgG may increase the risk of adverse prognosis at 14 days (or discharge) after onset of ischemic stroke,the risk may increase with the HSV-2 IgG level elevated.