Hp^+十二指肠溃疡患者外周血T淋巴细胞亚群与组织学炎症及Gas,SS含量的相关性  

Relationship of T lymphocyte subsets in peripheral blood with gastric mucosal active inflammation, Gas and SS contents in patients with duodenal ulcer

作　　者：聂昭华[1] 祝扬[1] 张敏[1] 冯方波[1] 陈悦[1] 王宝珍[1] 耿玉兰[1] 陈秀珍[1] 

机构地区：[1]解放军261医院消化科

出　　处：《世界华人消化杂志》1999年第4期338-340,共3页World Chinese Journal of Digestology

摘　　要：目的动态观察根除Ｈｐ前后外周血Ｔ淋巴细胞亚群与组织学急性炎症反应，以及与血清促胃液素（Ｇａｓ），血浆、胃液生长抑素（ＳＳ）含量之间的相关变化．方法Ｈｐ＋十二指肠溃疡（ＤＵ）男性患者３２例，年龄２３岁～５１岁．对照组２２例均为Ｈｐ－浅表性胃炎（ＣＳＧ）男性患者，年龄２２岁～４９岁．两组患者均于空腹下作内镜，留取胃液，并在胃窦取组织，常规作尿素酶试验和组织学检查．同时取静脉血，采用ＡＰＡＡＰ方法和放射免疫法检测外周血Ｔ淋巴细胞亚群及血清Ｇａｓ，血浆ＳＳ含量．ＤＵ组患者接受抗Ｈｐ三联治疗，并于治疗后６０ｄ分别重复上述检查．结果３２例中，失访８例，余２４例Ｈｐ根除２０例（８３３％），未根除４例（１６７％）．抗菌治疗前，３２例ＤＵ患者Ｔ淋巴细胞亚群ＣＤ３（％），ＣＤ４（％）及ＣＤ４／ＣＤ８比值（３７０±１２，１９９±１０，１０±０１）显著低于对照组（５０５±１５，Ｐ＜００１；２７０±１３，Ｐ＜００５；１７±０１，Ｐ＜００１）；ＣＤ８（％）虽较对照组增高（２５５±２１ｖｓ１７７±１１），但无统计学意义．２０例Ｈｐ根除者中，ＣＤ３（％），ＣＤ４（％）及ＣＤ４／ＣＤ８比值上升的患者?AIM To study the relationship of T lymphocyte subsets in peripheral blood, gastric mucosal active inflammation, serum Gas and SS in plasma and gastric juice before and after Hp eradication. METHODS Thirty two male patients with Hp positive duodenal ulcer (DU) and 22 patients with Hp negative chronic superificial gastritis (CSG) as controls were assessed by histology and rapid urease test. Mucosa and gastric juice were obtained with endoscopy. The patients with DU were treated by triple anti Hp therapy. Hp and inflammation in gastric mucosa, T lymphocyte subsets in peripheral blood and Gas level in serum, SS content in plasma and gastric juice were measured before and after treatment. RESULTS CD3 (%), CD4 (%) and CD4/ CD8 in 32 DU patients (37 0±1 2, 19 9±1 0, 1 0±0 2) were significantly lower than those of 22 CSG controls (50 5±1 5, P <0 01; 27 0±1 3, P <0 05; 1 7±0 1, P <0 01 respectively). CD8 (%) in DU patients was higher than that of the controls (25 5±2 1 vs 17 7±1 1), but the difference was not significant. Of 20 DU patients after Hp eradication, CD3(%) and CD4/ CD8 were improved in 16 (80%), 13 (65%) and 18 (90%) patients respectively. CD8 (%) was decreased in 18 (90%) patients. There were significant differences in CD4 (%) and CD4/ CD8 ratio before and after treatment. Accompanying by the degree of acute inflammation of gastric mucosa, the CD8 (%) was gradually increased in patients with Hp positive. There were significant differences among three degrees of acute inflammation group (Ⅰ/ Ⅱ/ Ⅲ, 19 9±2 6, 22 1±3 4, 29 1±6 8, P <0 01). Before Hp eradication, CD4/ CD8 was inversely correlated with the contents of Gas in serum and SS in plasma and gastric juice ( r =0 492, P <0 05; r =0 789, P <0 001) in DU patients. The close relationship suggested that the secretions of Gas and SS had an important effect on immune cells in DU patients under certain circumstances. CONCLUSION In Hp + DU patie

关 键 词：十二指肠溃疡 幽门螺杆菌 T淋巴细胞亚群 炎症 

分 类 号：R573.103[医药卫生—消化系统]