【摘要】 目的探讨幽门螺杆菌（helicobacter pylori,HP）感染与急性缺血性脑卒中（acute ischemic stroke,AIS）不良预后的关系。方法于2011年6月²013年12月在中国7省14家医院纳入AIS首发病人,建立研究队列。在患者入院24 h内采集静脉血样本,检验HP-IgG含量,并在发病后1年时进行随访,调查和收集不良预后信息。采用Cox回归模型分析HP-IgG水平和AIS不良预后的关系。结果共纳入AIS患者1 150人,HP-IgG M(P₂₅,P₇₅)为10.14（7.39,15.05）ng/L。患者病后至1年时死亡、心血管事件、心血管死亡以及死亡或心血管事件发生率分别为4.83%、7.90%、3.72%和11.43%。应用Cox回归模型调整多因素后,以G1为比较组,G4组发生死亡和心血管死亡的风险升高,HR（95%CI）值分别为3.43（1.26⁹.36）和5.45（1.57¹8.90）;G2组、G3组、G4组发生死亡或心血管事件的风险升高,HR（95%CI）值分别为1.84（1.02³.34）、2.00（1.12³.56）和1.97（1.10³.55）;且随着HP-IgG水平升高,发生死亡、心血管死亡以及死亡或心血管事件的风险升高（均有P<0.05）。结论 HP感染是AIS不良预后的危险因素,高水平的HP-IgG能增加AIS发病1年后死亡、心血管死亡以及死亡或心血管事件的发生风险。更多还原

【Abstract】 Objective To examine the association between helicobacter pylori（ HP） infection and the adverse prognosis at 1 year after onset of acute ischemic stroke（ AIS）. Methods From June 2011 to December 2013,first onset cases of AIS were collected from 14 hospitals in 7 provinces of China to establish research cohort. The venous blood sample of patients was taken to do HP-IgG content test within 24 hours after admission. The follow-up was conducted at 1 year after the onset of AIS,and the adverse prognosis outcome information was investigated and collected. Cox regression models were applied to estimate the association between different quartile levels of HP-IgG and different prognosis outcomes. Results A total of 1 150 AIS cases was conducted in the study. The M( P₂₅,P₇₅) of venous HP-IgG was 10. 14（ 7. 39,15. 05）ng/L. Within 1 year after AIS onset,the incidence of all-cause death,cardiovascular events cardiovascular death and death or cardiovascular events was 4. 83%,7. 90%,3. 72% and 11. 43%,respectively. After adjustment for multiple factors,Cox regression model showed that the risk of all-cause mortality and cardiovascular death increased in G4 group compared to the G1 group,and the HR（ 95% CI） was 3. 43（ 1. 26-9. 36） and 5. 45（ 1. 57-18. 90）,respectively; The risk of death or cardiovascular events increased in G2,G3 and G4 group compared to G1 group,and the HR（ 95% CI） was 1. 84（ 1. 02-3. 34）,2. 00（ 1. 12-3. 56） and 1. 97（ 1. 10-3. 55）,respectively; the 1 year risks of mortality and death or cardiovascular events were both increased with the level elevated in quartile groups,and the test of tendency was statistically significant（ all P < 0. 05）. Conclusions HP infection is the risk factor of AIS adverse prognosis. High HP-IgG level can increase the risk of mortality,cardiovascular death and death or cardiovascular event within 1 year after AIS onset.更多还原