缺血性中风风险与幽门螺杆菌感染和根除状态的关系:大规模前瞻性观察队列研究》。

IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Gut and Liver Pub Date : 2024-07-15 Epub Date: 2024-05-07 DOI:10.5009/gnl230458
Eun-Bi Jeon, Nayoung Kim, Beom Joon Kim, In-Chang Hwang, Sang Bin Kim, Ji-Hyun Kim, Yonghoon Choi, Yu Kyung Jun, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee, Soyeon Ahn
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引用次数: 0

摘要

背景/目的: :一些研究表明幽门螺杆菌(HP)感染与缺血性中风之间存在关联。然而,根除幽门螺杆菌对中风风险的影响尚未得到很好的评估。本研究旨在评估根除幽门螺杆菌对缺血性中风发病率的影响,同时考虑性别的潜在影响:这项前瞻性观察性队列研究于 2003 年 5 月至 2023 年 2 月在首尔国立大学盆唐医院进行,涉及基于胃镜的 HP 检测。研究采用倾向评分(PS)匹配法,将HP根除组患者(2803人)与HP未根除组患者(960人)按3:1的比例进行匹配,以确保组间平衡。采用 Cox 比例危险回归分析评估缺血性中风的风险:在 6664 名患者中,PS 匹配后的多变量分析表明,根除 HP 并未显著改变缺血性中风的风险(危险比为 0.531;95% 置信区间为 0.221 至 1.270;P=0.157)。单变量和多变量性别亚组分析均未发现统计学上的显著差异。然而,卡普兰-梅耶尔分析显示了一种潜在的趋势:根除 HP 组的女性缺血性中风发病率低于未根除 HP 组,但未达到统计学意义(P=0.057):这一发现表明,根除 HP 可能不会影响缺血性中风的风险。然而,有趋势表明,女性在根除 HP 后发生缺血性中风的风险可能较低,但要确定确切的证据还需要进一步的调查。
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Risk of Ischemic Stroke in Relation to Helicobacter pylori Infection and Eradication Status: A Large-Scale Prospective Observational Cohort Study.

Background/aims: : A few studies have suggested the association between Helicobacter pylori (HP) infection and ischemic stroke. However, the impact of HP eradication on stroke risk has not been well evaluated. This study aimed to assess the influence of HP eradication on the incidence of ischemic stroke, considering the potential effect of sex.

Methods: : This prospective observational cohort study was conducted at Seoul National University Bundang Hospital, from May 2003 to February 2023, and involved gastroscopy-based HP testing. Propensity score (PS) matching was employed to ensure balanced groups by matching patients in the HP eradicated group (n=2,803) in a 3:1 ratio with patients in the HP non-eradicated group (n=960). Cox proportional hazard regression analysis was used to evaluate the risk of ischemic stroke.

Results: : Among 6,664 patients, multivariate analysis after PS matching indicated that HP eradication did not significantly alter the risk of ischemic stroke (hazard ratio, 0.531; 95% confidence interval, 0.221 to 1.270; p=0.157). Sex-specific subgroup analyses, both univariate and multivariate, did not yield statistically significant differences. However, Kaplan-Meier analysis revealed a potential trend: the females in the HP eradicated group exhibited a lower incidence of ischemic stroke than those in the HP non-eradicated group, although this did not reach statistical significance (p=0.057).

Conclusions: : This finding suggests that HP eradication might not impact the risk of ischemic stroke. However, there was a trend showing that females potentially had a lower risk of ischemic stroke following HP eradication, though further investigation is required to establish definitive evidence.

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来源期刊
Gut and Liver
Gut and Liver 医学-胃肠肝病学
CiteScore
7.50
自引率
8.80%
发文量
119
审稿时长
6-12 weeks
期刊介绍: Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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