幽门螺杆菌感染患者外周血细胞因子的改变及临床意义  

Change of peripheral blood cytokines in patients with Helicobacter pylori infection and its clinical significance

作　　者：祝旭清 王国祥[1] 王建文[1] 缪杨德 王宏刚[1] 

机构地区：[1]台州市立医院消化内科,浙江台州318000

出　　处：《中华医院感染学杂志》2016年第17期3878-3880,共3页Chinese Journal of Nosocomiology

基　　金：浙江省科技攻关计划基金资助项目(2010C31022)

摘　　要：目的分析幽门螺杆菌(Hp)感染伴消化性溃疡(PU)患者血液细胞因子的改变,并探讨其临床意义,以期为该类疾病的临床诊疗提供参考。方法分析2013年1月-2015年1月在医院接受诊疗的70例Hp感染伴PU患者的临床资料,设为观察组,另选同期55例体检发现Hp感染但未PU的患者作为对照组;采用酶联免疫吸附法分析对比两组患者外周血细胞因子及炎症因子,分析各指标间的相关性及对PU的诊断价值。结果观察组患者外周血CagA 27.81±8.25U/ml与CRP 9.32±2.13mg/L水平显著高于对照组12.86±6.53U/ml、4.98±1.55mg/L,但IL-9 78.31±21.63ng/L水平显著低于对照组95.31±23.71ng/L,相比较差异均具有统计学意义(P<0.05);相关性分析显示观察组患者CagA水平与CRP(r=0.697,P<0.01)正相关,而与IL-9(r=-0.718,P<0.01)负相关;ROC曲线分析显示,以19.98U/ml为截点值,CagA诊断Hp感染者合并PU的敏感性为91.43%,特异性为87.27%,曲线下面积为0.93。结论 Hp感染者CagA水平升高可能是导致PU的原因之一,此外CagA还具有一定鉴别Hp感染者是否合并PU的临床价值。OBJECTIVE To investigate the change of serum cytokines in Helicobacter pylori infection patients complicated with peptic ulcer（PU）and explore the clinical significance so as to provide guidance for clinical diagnosis and treatment of the disease.METHODS The clinical data of 70 H.pylori infection patients complicated with PU who were treated in the hospital from Jan 2013 to Jan 2015 were analyzed,and the patients were assigned as the observation group;meanwhile,55 H.pylori infection patients without PU who received the physical examination were set as the control group.The peripheral blood cytokines and inflammatory factors were observed and compared by using enzyme-linked immunosorbent assay,and the relationship among the indicators and the value of the indicators in diagnosis of PU were analyzed.RESULTS The level of peripheral blood CagA of the observation was27.81±8.25U/ml,significantly higher than 12.86±6.53U/ml of the control group;the level of CRP of the observation group was 9.32±2.13mg/L,significantly higher than 4.98±1.55mg/L of the control group;however,the level of IL-9of the observation group was 78.31±21.63ng/L,significantly lower than 95.31±23.71ng/L of the control group（P〈0.05）.The correlation analysis indicated that the CagA level of the observation group was positively correlated with CRP（r=0.697,P〈0.01）but was negatively correlated with IL-9（r=-0.718,P〈0.01）.The ROC curve analysis showed that as the cutoff value was set as 19.98U/ml,the sensitivity of the CagA was 91.43%in the diagnosis of the H.pyloriinfection patients complicated with PU,the specificity 87.27%,and the area under ROC curve was 0.93.CONCLUSIONThe elevated level of CagA may be one of the causes of PU in the H.pylori infection patients,furthermore,the CagA has certain clinical value in determining whether the H.pylori infection patients are complicated with PU.

关 键 词：感染 幽门螺杆菌 消化性溃疡 细胞因子 白介素 

分 类 号：R378[医药卫生—病原生物学]