幽门螺杆菌对患者缺血性卒中复发与血流动力学的影响

发布时间：2018-04-05 19:13

本文选题：Hp感染　切入点：缺血性卒中　出处：《中华医院感染学杂志》2017年13期

【摘要】：目的探究幽门螺杆菌(Hp)感染对缺血性卒中复发以及血流动力学的影响。方法选取2011年1月-2013年1月于医院接受治疗的146例缺血性卒中患者为研究对象,对患者进行13 C尿素呼气试验并根据检验结果将患者分为两组,其中58例发生Hp感染的患者为观察组,88例未发生感染的患者为对照组;比较两组患者总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、超敏C-反应蛋白(hs-CRP)、纤维蛋白原(Fg)等指标含量;治疗2周后比较两组患者缺血性卒中临床疗效;比较两组患者颈动脉狭窄和颈动脉粥样硬化分布情况;检测患者大脑前动脉(ACA)、双侧大脑中动脉(MCA)、大脑后动脉(PCA)和颈内动脉末端(TICA)的血流平均流速(Vm)、平均血流量(Qm)、脉动指数(PI);所有患者出院后进行为期3年的随访,比较两组患者出院后1年、2年、3年复发率及死亡率。结果两组患者血脂指标、炎症因子以及Hp抗体比较,差异有统计学意义(P0.05);观察组治疗有效率为67.2%,对照组为84.1%,两组比较差异有统计学意义(P0.05);观察组颈动脉狭窄和颈动脉粥样硬化高于对照组,两组比较差异有统计学意义(P0.05);观察组与对照组不同动脉血流平均速度、平均血流量比较,差异有统计学意义(P0.05),且两组患者特性阻抗(Zc)与动态阻力(DR)比较,差异有统计学意义(P0.05);观察组出院3年后复发率与死亡率高于对照组,差异有统计学意义(P0.05)。结论 Hp感染不利于缺血性卒中患者临床治疗疗效的提高,对患者血流动力学有不利影响,患者出院后复发率与死亡率较高,临床应对此类患者进行加强控制以提高生存质量。
[Abstract]:Objective to investigate the effects of Helicobacter pylori (HP) infection on ischemic stroke recurrence and hemodynamics.Methods 146 patients with ischemic stroke who were treated in hospital from January 2011 to January 2013 were selected and divided into two groups according to the results of 13C urea breath test.There were 58 cases of HP infection in the observation group and 88 cases in the control group.The contents of TC, TG, HDL-CU, LDL-Cn, HS-CRPU, FG were compared between the two groups, and the clinical efficacy of the two groups was compared after 2 weeks of treatment.The distribution of carotid artery stenosis and carotid atherosclerosis were compared between the two groups.The recurrence rate and mortality rate of 1, 2 and 3 years after discharge were compared between the two groups.Results Serum lipids, inflammatory factors and HP antibodies were compared between the two groups.The effective rate of treatment was 67.2 in the observation group and 84.1 in the control group, and the difference between the two groups was statistically significant (P 0.05), the carotid artery stenosis and carotid atherosclerosis in the observation group were higher than those in the control group.The difference between the two groups was statistically significant (P 0.05), the mean blood flow velocity and mean blood flow of different arteries in the observation group and the control group were significantly higher than those in the control group (P 0.05), and the characteristic impedance of the two groups was compared with that of the dynamic resistance (DRR).The recurrence rate and mortality in the observation group were higher than those in the control group, and the difference was statistically significant.Conclusion HP infection is unfavorable to the improvement of clinical therapeutic effect and has adverse effect on hemodynamics of patients with ischemic stroke. The recurrence rate and mortality rate of patients after discharge from hospital are higher. It is necessary to strengthen the control of these patients in order to improve the quality of life.
【作者单位】：郑州大学第五附属医院神经内科;
【分类号】：R743.3

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