摘要
目的分析老年急性脑梗死患者幽门螺杆菌(Hp)感染与血脂水平及血清肿瘤坏死因子-α(TNF-α)的相关性。方法选取2017年1月-2018年12月上饶市立医院收治的急性脑梗死老年患者102例,根据患者Hp感染情况,分为未感染组(n=54)、轻度感染组(n=30)和重度感染组(n=18),检测患者血清TNF-α、白细胞介素-6(IL-6)、C-反应蛋白(CRP)及血脂水平,比较各组患者临床指标。结果三组患者血清炎性指标(TNF-α、IL-6及CRP)、血脂指标[甘油三脂(TG)和低密度脂蛋白胆固醇(LDL-C)]、颈动脉斑块情况(IMT值、斑块发生率及不稳定斑块发生率)及随访期情况(急性脑梗死复发)的比较,差异有统计学意义(P<0.05);未感染组、轻度感染组及高度感染组TNF-α、IL-6、CRP及IMT均依次升高,组间比较差异有统计学意义(P<0.05);与未感染组比较,Hp感染的急性脑梗死患者TG和LDL-C水平升高(P<0.05);与未感染组比较,重度感染组急性脑梗死复发率升高(P<0.05);急性脑梗死患者颈动脉IMT分别与炎性指标TNF-α、IL-6及CRP、血脂指标TG和LDL呈正相关(P<0.05)。结论Hp感染会影响老年急性脑梗死患者血脂水平和血清TNF-α等炎性因子水平,可能由此介导动脉粥样硬化,促进脑梗死的发生发展。
OBJECTIVE To analyze the correlation between Helicobacter pylori(Hp)infection and blood lipid level and serum tumor necrosis factorα(TNF-α)in elderly patients with acute cerebral infarction(ACI).METHODS A total of 102elderly ACI patients who were admitted to Shangrao Municipal Hospital from Jan.2017to Dec.2018 were enrolled.According to presence or absence of Hp infection,they were divided into the non-infection group(n=54),mild infection group(n=30)and severe infection group(n=18).The levels of serum TNF-α,interleukin 6(IL-6),C-reactive protein(CRP)and blood lipid were measured.The clinical indicators were compared among all groups.RESULTS There were significant differences in serum inflammatory indexes(TNF-α,IL-6,CRP),blood lipid indexes(TG,LDL-C),carotid plaque status,such as intima-media thickness(IMT)value,plaque incidence and unstable plaque ratio,and the ACI recurrence during the follow-up period among the three groups(P<0.05).TNF-α,IL-6,CRP and IMT in the non-infection group,mild infection group and severe infection group were increased in turn.There were significant differences among different groups(P<0.05).Compared with the non-infection group,levels of TG and LDL-C in ACI patients with Hp infection were significantly higher(P<0.05).There was no significant difference between the severe infection group and mild infection group.The recurrence rate of acute cerebral infarction was significantly higher in the severe infection group than that in the non-infection group(P<0.05).Carotid IMT in ACI patients was positively correlated with inflammatory indexes(TNF-α,IL-6and CRP)and blood lipid indexes(TG and LDL)(P<0.05).CONCLUSION Hp infection will affect levels of blood lipid and serum inflammatory factors(TNF-α)in elderly ACI patients,which may mediate atherosclerosis,and promote occurrence and development of cerebral infarction.
作者
沈小忠
李霞
程世宏
刘旭明
黄荣
SHEN Xiao-zhong;LI Xia;CHENG Shi-hong;LIU Xu-ming;HUANG Rong(Shangrao Municipal Hospital,Shangrao,Jiangxi 334000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第20期3090-3094,共5页
Chinese Journal of Nosocomiology
关键词
急性脑梗死
幽门螺杆菌感染
血脂
肿瘤坏死因子-Α
老年患者
Acute cerebral infarction
Helicobacter pylori infection
Blood lipid
Tumor necrosis factorα
Elderly patient
