中西医结合根除幽门螺杆菌对萎缩性胃炎核因子-κB表达的影响  

Effect of eradication Helicobacter pylori on NF-κB expression in Helicobacter pylori-positive chronic atrophic gastritis

作　　者：吴灵飞[1] 蒲泽锦[1] 苏剑东[2] 冯家琳[3] 李国平 王炳周[1] 

机构地区：[1]汕头大学医学院第二附属医院消化内科,广东汕头515041 [2]遵义医学院第五附属(珠海)医院消化内科,广东珠海519100 [3]汕头大学医学院第二附属医院信息科,广东汕头515041

出　　处：《中国中西医结合消化杂志》2008年第6期377-380,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：广东省中医药管理局资助(1050136)

摘　　要：[目的]观察以胃舒散为主的三联疗法(胃舒散、呋喃唑酮和克拉霉素)治疗幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的临床效果及其对核因子-κB(NF-κB)表达的影响。[方法]41例Hp阳性CAG患者服用胃舒散2.0g,呋喃唑酮0.1g,各3次/d,克拉霉素0.25g,2次/d,1周后再继服胃舒散4周。治疗前及治疗结束1年后行内镜及病理组织学检查,取活检观察病理组织学改变及NF-κB表达变化,采用银染色法、14C-尿素呼气试验或快速尿素酶试验检测Hp。[结果]三联疗法结束1年后,Hp根除率为85.4%;根除Hp能显著减轻患者胃窦部慢性炎症(P<0.05)和活动程度(P<0.01),下调NF-κB表达(P<0.01),但胃炎的萎缩和肠化生等病理无明显改变。[结论]以胃舒散为主的三联疗法对Hp有较高根除率。根除Hp可抑制NF-κB的表达,减轻活动性炎症,但近期观察对萎缩、肠化生等病理改变无明显作用。[Objective]To evaluate the effect of Weishusan combined with furazolidone and claramycillin on the eradication of Helicobacter pylori （Hp） and on chronic atrophic gastritis as well as the expression of NF-κB in the gastric mucosa. [Methods]Forty one patients with Hp positive chronic atrophic gastritis conformed by endoscopy were received Weishusan 2. 0 （containing Bi 0. 12）, furazolidone 0. 1, bid, claramycillin 0. 25, rid for 1 weeks, and continued to receive Weishusan 2.0 tid for 4 weeks. An endoscopy with biopsy samples was performed before and one year after therapy. Hp was determined by histology of warthin-starry silver stain, ^14 C-urine breath test or rapid urease test. Biopsy specimens were analyzed by histological methods. The expression of NF-κB in the gastric mueosa was tested by immunohistoehemistry. [Results]Hp eradication rate was 85.4% after one year of the combined therapy. In patients with Hp eradication （n=31）, the chronic inflammation and active degree of gastric antrum were significantly relieved （P〈0. 05 and P〈0.01 respectively）; The expression of NF-κB was significantly down-regulated （P〈0. 01）, however,there were no significant differences in the atrophy and intestinal metaplasia pathology before and after Hp eradication （ both P〉0. 05 ）. [Conclusion ]The combined therapy with Weishusan, furazolidone and claramyeillin is highly effective in Hp eradication. The eradication of Hp significantly inhibited the activation of NF-κB and decreased the chronic active gastritis, but not improved atrophic pathohistology in gastric mucosa.

关 键 词：胃炎 萎缩性 幽门螺杆菌 核因子-ΚB 

分 类 号：R573.3[医药卫生—消化系统]