發(fā)布時(shí)間：2018-04-05 19:13

  本文選題：Hp感染　切入點(diǎn)：缺血性卒中　出處：《中華醫(yī)院感染學(xué)雜志》2017年13期

【摘要】：目的探究幽門(mén)螺桿菌(Hp)感染對(duì)缺血性卒中復(fù)發(fā)以及血流動(dòng)力學(xué)的影響。方法選取2011年1月-2013年1月于醫(yī)院接受治療的146例缺血性卒中患者為研究對(duì)象,對(duì)患者進(jìn)行13 C尿素呼氣試驗(yàn)并根據(jù)檢驗(yàn)結(jié)果將患者分為兩組,其中58例發(fā)生Hp感染的患者為觀察組,88例未發(fā)生感染的患者為對(duì)照組;比較兩組患者總膽固醇(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-反應(yīng)蛋白(hs-CRP)、纖維蛋白原(Fg)等指標(biāo)含量;治療2周后比較兩組患者缺血性卒中臨床療效;比較兩組患者頸動(dòng)脈狹窄和頸動(dòng)脈粥樣硬化分布情況;檢測(cè)患者大腦前動(dòng)脈(ACA)、雙側(cè)大腦中動(dòng)脈(MCA)、大腦后動(dòng)脈(PCA)和頸內(nèi)動(dòng)脈末端(TICA)的血流平均流速(Vm)、平均血流量(Qm)、脈動(dòng)指數(shù)(PI);所有患者出院后進(jìn)行為期3年的隨訪,比較兩組患者出院后1年、2年、3年復(fù)發(fā)率及死亡率。結(jié)果兩組患者血脂指標(biāo)、炎癥因子以及Hp抗體比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組治療有效率為67.2%,對(duì)照組為84.1%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組頸動(dòng)脈狹窄和頸動(dòng)脈粥樣硬化高于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組與對(duì)照組不同動(dòng)脈血流平均速度、平均血流量比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),且兩組患者特性阻抗(Zc)與動(dòng)態(tài)阻力(DR)比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組出院3年后復(fù)發(fā)率與死亡率高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 Hp感染不利于缺血性卒中患者臨床治療療效的提高,對(duì)患者血流動(dòng)力學(xué)有不利影響,患者出院后復(fù)發(fā)率與死亡率較高,臨床應(yīng)對(duì)此類(lèi)患者進(jìn)行加強(qiáng)控制以提高生存質(zhì)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.
【作者單位】： 鄭州大學(xué)第五附屬醫(yī)院神經(jīng)內(nèi)科;
【分類(lèi)號(hào)】：R743.3

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本文編號(hào)：1716106