根除Hp治疗对高原地区Hp相关性溃疡患者血清6种细胞因子水平的影响及其临床意义  

Changes of serum cytokines and clinical significance in patients with Hp-associated ulcers after Hp eradication therapy in plateau area

作　　者：杨永耿[1] 熊元治[1] 王建云[1] 马颖才[1] 丹珠永吉[1] 于梅花[2] 韵文萍[2] 银措[2] 兰生梅[1] 杜娟[1] 李英存[1] 林碧霞[1] 蔡宏澜[1] 

机构地区：[1]青海省人民医院消化科,西宁810007 [2]青海省人民医院核医学科,西宁810007

出　　处：《临床内科杂志》2006年第2期93-95,共3页Journal of Clinical Internal Medicine

基　　金：青海省卫生厅科学研究基金项目资助(编号Y167-2003-30)

摘　　要：目的观察根除幽门螺杆菌治疗对高原地区幽门螺杆菌相关性溃疡病患者血清IL-1β、IL-2、IL-4、IL-6、IL-8和TNF水平的影响,以探讨其在溃疡病发病中的可能致病机理。方法应用放射免疫法测定55例溃疡病患者血清6种细胞因子的含量,比较幽门螺杆菌感染与非感染患者含量的差异,对幽门螺杆菌感染患者进行以洛赛克为中心的三联1周疗法,比较根除前后及根除者和未根除者其含量的差异,同时比较幽门螺杆菌根除组和未根除组溃疡的愈合率。结果55例患者中,幽门螺杆菌感染者30例,感染者血清IL-4含量明显低于非感染者(P<0.01),幽门螺杆菌根除后其含量极明显高于根除前(P<0.001),未根除者前后比较无变化(P>0.05),根除者明显高于未根除者(P<0.05),而根除幽门螺杆菌治疗对IL-1β、IL-2、IL-6、IL-8和TNF均无显著性影响(P>0.05),幽门螺杆菌根除组溃疡愈合率明显高于未根除组(P<0.05)。结论幽门螺杆菌感染后IL-4降低导致的Th2免疫应答下调可能是幽门螺杆菌相关性溃疡病发生的主要致病机制之一;根除幽门螺杆菌可使IL-4分泌明显增加,Th2免疫应答上调,从而加速溃疡愈合;血清IL-4的检测有望成为根除幽门螺杆菌和溃疡愈合疗效判定的有用指标。Objective To observe the effect of Hp eradication therapy on serum IL-1β, IL-2,IL- 4, IL-6, IL-8 ,TNF in patients with Hp-associated ulcers, and to explore possible pathogenesis that Hp causes peptic ulcer disease. Methods Six cytokines in 55 cases with peptic ulcer were detected by radio immunoassay, the difference of cytokine level between Hp infected patients and Hp non-infected patients were compared. Hp infected patients were given Hp eradication therapy. Results There were 30 cases of Hp infection in 55 cases of peptic ulcer disease. The serum IL-4 levels in Hp infected patients were significantly lower than those in non-Hp infected patients （P 〈 0.01 ） and increased obviously after Hp eradication（ P 〈0.001 ）. The serum IL-4 levels remained unchanging in the patients with an unsuccessful Hp eradicated. The serum levels of other cytokines did not change markedly （ P 〉 0.05） after Hp eradication. The healing rate in Hp successful eradication cases was higher significantly than that in Hp unsuccessful eradication ones. Conclusion The downregulation of Th2 immune response resulted from IL-4 decrease after Hp infection may be a major pathogenesis in Hp-associated peptic ulcer. The upregulation of Th2 immune response resulted from increased IL-4 after Hp successful eradication enhanced ulcer healing. The serum IL-4 could be used as an useful parameter to assess the effects of Hp eradication and ulcer healing.

关 键 词：高原 幽门螺杆菌 消化性溃疡病 细胞因子 

分 类 号：R573.1[医药卫生—消化系统]