目的 研究幽门螺杆菌(helicobacter pylori,Hp)感染及同型半胱氨酸(homocysteine,Hcy)与急性缺血性卒中(acute ischemic stroke,AIS)短期结局的相关性.方法 采用前瞻性队列研究的方法,纳入唐山工人医院2014年1-12月的120例首发AIS患者.入院后测定Hp-IgG阳性率、Hcy水平,进行美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分,收集其他可能影响短期结局的相关因素(包括一般临床资料及生化指标).对患者进行短期结局(发病2个月)改良Rankin量表(modified Rankin Scale,mRS)评分.结果 ①短期结局不良组的Hp感染率及Hcy水平显著高于结局良好组,比较差异具有显著性(P<0.05).②以AIS短期结局为应变量,单因素Logistic回归分析发现,年龄、性别、基线NIHSS评分、Hp感染及Hcy水平与AIS患者短期结局相关.③以AIS短期结局为应变量,单因素分析中P<0.05的因素为自变量,进行多因素Logistic回归分析,结果显示年龄[比值比(odds ratio,OR)=1.021,P=0.017]、基线NIHSS评分(OR=2.318,P<0.001)、Hp感染(OR=1.038,P=0.008)、Hcy(OR=1.029,P<0.001)与AIS患者短期结局不良相关.结论 Hp感染、高Hcy血症是AIS患者短期结局不良的危险因素.%Objective To study the relationship between Helicobacter pylori (Hp) infection, homocysteine (Hcy) and short-term outcome of acute ischemic stroke (AIS). Methods A prospective cohort study was conducted. A total of 120 patients with primary-acute ischemic stroke were enrolled in Tangshan Gongren hospital. The Hp-IgG and Hcy levels were measured, and the National Institutes of Health Stroke Scale (NIHSS) was performed after admission, and other related factors (including general clinical data and biochemical indexes) were collected. Modified Rankin Scale (mRS) at Month 2 after onset was performed when the patients were in admission and at discharge. Results (1) The Hp infection rate and the Hcy level of the poor-outcome group were higher than that in good-outcome group, and the difference was statistically significant (P<0.05). (2) Univariate logistic regression analysis showed that age, sex, NIHSS score, Hcy level and Hp infection were associated with short-term outcome of AIS patients. (3) Multivariate logistic regression showed age (OR=1.021,P=0.017), NIHSS Score (OR=2.318,P<0.001), Hp infection (OR=1.038,P=0.008), Hcy(OR=1.029,P<0.001)were correlated with short-term outcome of acute ischemic stroke. Conclusion Hp infection and elevated homocysteine level were the risk factors for short-term outcomes in patients with acute ischemic stroke.
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