根除幽门螺杆菌对早期糖尿病肾病患者微炎症反应的影响  

Down-regulating microinflammation by Helicobacter pylori eradication therapy in patients with early diabetic nephropathy

作　　者：沈建明[1] 刘玲[1] 刘艳红[2] 王黎萍[1] 李骏峰[1] 

机构地区：[1] 湖北医药学院附属人民医院肾病内科,湖北十堰442000 [2] 湖北医药学院附属人民医院药学部,湖北十堰442000

出　　处：《临床内科杂志》2015年第1期48-50,共3页Journal of Clinical Internal Medicine

摘　　要：目的 观察根除幽门螺杆菌（HP）对早期糖尿病肾病（DN）患者微炎症反应的影响.方法 将80例合并HP感染的早期DN患者随机分为HP对照组和HP治疗组,并选取40例未合并HP感染的早期DN患者作为DN对照组,HP治疗组接受根除HP治疗.HP对照组和HP治疗组在治疗3个月后再次评价幽门螺杆菌感染情况;3组均于治疗前及治疗3个月后检测患者血糖、糖化血红蛋白（HbA1C）、尿微量白蛋白/尿肌酐（ACR）、肾功能、血脂以及血清超敏C反应蛋白（hs-CRP）、肿瘤坏死因子（TNF）-α、白细胞介素（IL）-1β、IL-6和IL-8以及单核细胞趋化蛋白-1（MCP-1）以及细胞间黏附分子-1（ICAM-1）水平并予以比较.结果 在治疗前以及治疗3个月后3组间血糖、HbA1C、ACR、肾功能、血脂水平比较差异无统计学意义（P＞0.05）.HP治疗组HP转阴率明显高于HP对照组（P＜0.05）.治疗前HP对照组和HP治疗组ACR、hs-CRP、TNF-α、IL-13、IL-6、IL-8、MCP-1和ICAM-1水平比较差异无统计学意义（P＞0.05）,但均高于DN对照组（P＜0.05）;HP治疗组治疗3个月后ACR、hs-CRP、TNF-α、IL-1β、IL-6、IL-8、MCP-1和ICAM-1水平低于治疗前且低于HP对照组（P＜0.05）.结论 根除HP可以降低早期DN患者体内炎症因子水平,减轻微炎症反应.Objective To observe effects of Helicobacter pylori（HP） eradication therapy on mi- croinflammation in patients with early diabetic nephropathy （DN）. Methods Eighty early DN patients with HP infection were randomly divided into HP control group and HP treatment group with 40 patients in each group, with 40 DN patients without HP infection DN in control group. Patients in HP treatment group were administered by Helicobacter pylori eradication therapy. HP infection were detect in both HP control group and HP treatment group at 3 months after treatment. Urinary albumin/creatinine ratio（ ACR）, blood levels of sugar, glycosylated hemoglobin, blood urine nitrogen （ BUN ）, creatinine, lipid, high sensitivity C reactive protein （hs-CRP） , tumor necrosis factor （TNF） =or, intedeukin-113, intedeukin-6, interleukin-8, monoeyte chemotactic protein-1 （ MCP-1 ） and intercellular adhesion molecule-1 （ ICAM-1 ） were detected before and at 3 months after treatment. Results Rate negative of HP infection were higher in HP treat- ment group than in HP control group at 3 months after treatment. Before treatment, ACR, blood levels of hs-CRP,TNF-a,interleukin-l13,interleukin-6 interleukin-8, MCP-1 and ICAM-1 were higher in both HP control group and HP treatment group than in DN control group, and there existed no differences of these index between HP control group and HP treatment group. At 3 months after treatment, ACR, blood levels of hs-CRP,TNF-c~, interleukin-113, interleukin-6, interleukin=8, MCP-1 and ICAM-1 were lower than those before treatment in HP treatment group, and were lower in HP treatment group than in HP control group （ P 〈 0.05, respectively）. Conclusion HP eradication therapy can attenuate blood level of inflammation factor in early DN patients with HP up-regulated microinflammation.

关 键 词：幽门螺杆菌 糖尿病肾病 微炎症反应 

分 类 号：R654.2[医药卫生—外科学]