偏头痛患者先兆症状及幽门螺杆菌CagA-阳性株关系临床探究.docVIP

偏头痛患者先兆症状及幽门螺杆菌CagA-阳性株关系临床探究 　【摘要】 目的 探讨幽门螺杆菌（Hp）CagA-阳性菌株感染与偏头痛先兆的关系。方法 采用C13-尿素呼气试验确定Hp感染。两组全部的Hp感染者进行其幽门螺杆菌Ⅰ型CagA-阳性的菌株的测定,观察有先兆的偏头痛患者和无先兆的偏头痛患者HpCagA-阳性的菌株感染情况。同时观察抗Hp三联疗法的疗效。结果 有先兆的偏头痛患者其幽门螺杆菌Ⅰ型CagA-阳性的菌株的检出率（81.33％）显著高于无先兆的偏头痛患者的幽门螺杆菌Ⅰ型CagA-阳性的菌株的检出率（30.67％）（Plt;0.001）；经过4周的抗幽门螺杆菌治疗后，两组患者的幽门螺杆菌Ⅰ型CagA-阳性的菌株的检出率显著低于治疗前［分别为10.67%和6.67%；Plt;0.001和Plt;0.01（与治疗前相比）］。结论 幽门螺杆菌Ⅰ型CagA-阳性的菌株的感染可能是偏头痛患者先兆症状产生的原因。抗Hp治疗能显著改善偏头痛患者的先兆症状。 【关键词】 偏头痛 幽门螺杆菌 CagA-阳性菌株 Clinical study on association between Helicobacter pylori cytotoxic type I CagA-positive strains and migraine with aura ［Abstract］ Objective To study the association between Hp cytotoxic type I CagA-positive strains and migraine with aura.Methods The migraine patients were divided into two groups according to patients with or without aura.Hp were detected with C expiration test in migraine patients.The Hp infected patients were further detected for Hp cytotoxic type I CagA-positive strains.The curative effects of three combined anti-Hp infection treatment were observed.Results The infected rates of Hp cytotoxic type I CagA-positive strains in migraine patients with aura were significantly higher than that in migraine patients without aura（81.33％ vs 30.67％;Plt;0.001）.After four weeks’ anti-Hp therapy,the infected rates of Hp cytotoxic type I CagA-positive strains were lower in both groups than before.Conclusion Hp cytotoxic type I CagA-positive strains infection may probably be an important factor in pathogenesis of migraine with aura.Anti-Hp therapy may be effective in treatment to migraine patients with aura. ［Key words］ migrane;Helicobacter pylori；CagA-positive strains 偏头痛的发病机制至今尚不清楚，既往认为是一种脑血管舒缩功能障碍性疾病。但近几年的研究表明，幽门螺杆菌（H.pylori,Hp）感染在偏头痛的发病机制中亦起着较重要的作用。但是，典型的偏头痛发作具有先兆症状。偏头痛发作与幽门螺杆菌感染有关。那么，其先兆症状是否也与幽门螺杆菌感染有关呢？为探讨Hp CagA-阳性菌株感染与偏头痛先兆的关系，笔者对Hp感染的偏头痛患者进行了观察治疗，现报告如下。 1 资料与方法 1.1 一般资料 选取2000年1月～2002年6月于东莞市太平人民医院神经内科门诊就诊的偏头痛患者中，选择经C13-碳尿素呼气试验确定为Hp感染的偏头痛患者。将所有病例按有无先兆症状分为试验组、对照组，每组75例。全部患者符合1988年国际头痛协会（HIS）偏头痛诊断标准［1