消化性溃疡患者外周血细胞免疫及体液免疫功能变化分析  

Changes of Cellular Immune Function and Humoral Immune Function in Peripheral Blood of Patients With Peptic Ulcer

作　　者：吴蓉[1] 李国熊[1] 李丽[1] 周刚[1] 吴建良[1] 陈晶[1] 

机构地区：[1]杭州师范大学附属医院消化内科,浙江省杭州市310015

出　　处：《中国全科医学》2016年第20期2481-2485,共5页Chinese General Practice

摘　　要：目的探讨消化性溃疡患者外周血细胞免疫及体液免疫功能的变化及临床意义。方法选择2014年1月—2015年1月杭州师范大学附属医院门诊及住院的连续经胃镜确诊的消化性溃疡患者122例为溃疡组,另选择同期体检中心体检健康者70例为对照组,溃疡组患者根据是否感染幽门螺杆菌分为幽门螺杆菌阳性亚组(Hp+亚组)85例和幽门螺杆菌阴性亚组(Hp-亚组)37例,根据是否出血分为出血亚组58例和未出血亚组64例。检测外周血细胞免疫指标(包括CD_3、CD_4、CD_8、CD_4/CD_8、CD_(19)、CD_(56))及体液免疫指标(IgG、IgA、IgM、IgE、C_3、C_4)水平,出血亚组中30例大便隐血试验阳性患者大便隐血试验转阴后复查外周血细胞免疫指标及体液免疫指标。结果溃疡组患者外周血CD_3、CD_4、CD_4/CD_8、CD_(19)、CD_(56)、C_3、C_4水平较对照组降低,IgG水平较对照组升高(P<0.05);Hp+亚组患者外周血CD_3、CD_4、CD_8、CD_(19)、IgM、IgE水平较Hp-亚组升高,CD_4/CD_8较Hp-亚组降低(P<0.05);出血亚组患者外周血CD_3、CD_4水平、CD_4/CD_8较未出血亚组降低(P<0.05)。大便隐血试验阳性患者转阴后外周血CD_3、CD_4、CD_8、CD_(19)、CD_(56)、C_3、C_4水平较治疗前升高,IgG、IgM水平较治疗前降低(P<0.05)。结论消化性溃疡患者存在免疫功能调节紊乱,幽门螺杆菌感染可促使机体产生强烈的免疫反应,急性出血后免疫功能处于抑制状态,止血后免疫功能有所恢复。Objective To investigate the changes of cellular immune function and humoral immune function in peripheral blood of patients with peptic ulcer and the clinical significance. Methods From January 2014 to January 2015,we enrolled 122 patients who were definitely diagnosed as peptic ulcer in the Affiliated Hospital of Hangzhou Normal University as ulcer group,and enrolled 70 healthy people who received physical examination as control group. According to whether infection of helicobacter pylori occurred,the patients in ulcer group were divided into helicobacter pylori positive subgroup（ Hp ＋ subgroup）（ n = 85） and helicobacter pylori negative subgroup（ Hp- subgroup）（ n = 37）,and were divided into bleeding subgroup（ n =58） and non- bleeding subgroup（ n = 64） according to whether bleeding occurred. The indexes of cellular immune function（ including CD_3、CD_4、CD_8、CD_4/CD_8、CD_（19）、CD_（56）） and indexes of humoral immune function（ including IgG、IgA、IgM、IgE、C_3、 and C_4 ） in peripheral blood were detected. In bleeding subgroup,30 patints who had positive results in fecal occult blood testing received reexamination of the indexes of immune function and humoral immune function in peripheral blood after fecal occult blood testing showed negative results. Results The levels of CD_3、CD_4、CD_4/CD_8、CD_（19）、CD_（56）、C_3、and C_4in peripheral blood were lower in ulcer group than those in control group,the levels of Ig G in peripheral blood was higher in ulcer group than that in control group（ P〈 0. 05）; the levels of CD_3,CD_4,CD8,CD_（19）,IgM and IgE in peripheral blood were higher in Hp ＋ subgroup than those in Hp- subgroup,the CD_4/ CD_8 in peripheral blood was lower in Hp ＋ subgroup than that in Hp- subgroup（ P〈 0. 05）; the levels of CD_3,CD_4 and CD_4/ CD_8 in peripheral blood were lower in bleeding subgroup than those in non- bleeding subgroup（ P 〈0. 05）. The levels of CD_3、CD_4、CD_8、CD_（19）、CD_（56）、C_3

关 键 词：消化性溃疡 幽门螺杆菌 消化性溃疡出血 细胞免疫 体液免疫 

分 类 号：R573.1[医药卫生—消化系统]