慢性产细胞毒素相关蛋白A幽门螺杆菌感染与动脉硬化性脑梗塞的发病关系探讨

目的 :探讨慢性幽门螺杆菌 (HP)感染尤其是产细胞毒素相关蛋白 A(Cag A)的 HP菌株感染与脑梗塞的发病关系。方法 :应用酶联免疫法 (EL脑梗塞 A)和斑点金渗滤试验 (DIGFA)对 79例连续住院的脑梗塞患者血清中 HPIg G抗体和 HP-Cag A-Ig G抗体进行测定并设对照组比较。同时应用全自动生化分析仪测定血清总胆固醇 (CHO)、甘油三酯(TG)、载脂蛋白 A(Apo A)、载脂蛋白 B(Apo B)。应用血液流变学分析仪测定各项血液流变学指标。同时分析脑梗塞患者的高血压、糖尿病、心脏病、吸烟、饮酒等危险因素。结果 :脑梗塞组 HPIg G阳性率为 75.9% ,而对照组 HPIg G阳性率为 67.3 % ,两组比较无显著差异。脑梗塞组 HP-Cag A-Ig G阳性率为 3 9.4% ,而对照组为 1 9.7% ,两组比较有显著差异。 HP-Cag A-Ig G阳性脑梗塞患者的 TG水平和血液流变学指标与 HP-Cag A-Ig G阴性脑梗塞患者和对照组比较均显著升高。经多元 Logistic回归分析 ,发现慢性 Cag A阳性 HP菌株(Cag A+ -HP)感染与高血压、糖尿病、心脏病、吸烟、高粘血症、高脂血症一样为脑梗塞的发病危险因素。结论 :慢性 HP感染尤其是 Cag A+ -HP感染是脑梗塞发病的独立危险因素。

Preliminary exploration of the association between chronic Helicobacter pylori infection and ischemic stroke

Objective:To explore the association between Helicobacter pylori(HP) infection, especially the strains bearing the cytotoxin-associated gene-A(Cag-A) infection, and ischaemic stroke. Method:HP-IgG, HP-CagA-IgG and total cholesterol, triglyceride, apolipoprotein A, apolipoprotein B and blood viscosity were measured in 79 cases of acute ischaemic stroke patients, with 73 healthy subjects as controls. Result: The rates of seropositivity for HP-IgG and HP-CagA-IgG in patients with ischaemic stroke are significantly higher than that of controls (75.9% vs 53.4%, 35.4% vs 15.1%, P<0.01, respectively). The level of serum TG and blood viscosity indices in HP-CagA seropositivity patients is higher than that in HP-CagA seronegativity patients and controls (P<0.05). Logistic regression analysis indicated that HP infection is related positively to ischaemic stroke (p=0.045). Conclusion:HP infection, especially Cag-A-positive strains infection may be an important risk factor for ischaemic stroke.