胃炎患者幽门螺杆菌感染与血清学指标及病理的相关性  

Correlation between Helicobacter pylori infection and serum inflammatory indexes and pathological features in patients with gastritis

作　　者：代敏涛[1] 吴太宇[1] 张宇[1] 陈微微[1] 彭丹若[1] 聂军[1] DAI Min-tao;WU Tai-yu;ZHANG Yu;CHEN Wei-wei;PENG Dan-ruo;NIE Jun(Zunyi First Peoples Hospital,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义市第一人民医院消化内科

出　　处：《中华医院感染学杂志》2019年第24期3719-3723,共5页Chinese Journal of Nosocomiology

基　　金：贵州省科学技术基金资助项目[黔科合基础(2017)1210]

摘　　要：目的探讨幽门螺杆菌(Helicobacter pylori,Hp)感染与血清炎症因子、胃泌素、胃炎不同部位及病理学特征的相关性,为临床慢性胃炎防治措施的制定提供理论依据。方法选取2016年1月-2018年6月遵义市第一人民医院收治的慢性胃炎患者92例,将其中64例慢性萎缩性胃炎患者分为试验组,28例非慢性萎缩性胃炎患者分为对照组。采用酶联免疫吸附测定法(Enzyme-Linked Immuno Sorbent Assay,ELISA)检测血清白细胞介素-6(Interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、CagA蛋白及胃泌素水平,分析Hp感染与血清胃泌素水平的关系;比较两组患者胃黏膜的炎症程度、活动性以及肠化程度分级情况;比较两组患者Hp感染的情况;分析Hp感染率与慢性胃炎病理学特征的相关性。结果试验组患者炎症反应程度,活动性以及肠化程度分级均高于对照组,差异有统计学意义(P<0.05)。试验组的Hp感染率为71.88%,高于对照组的35.71%,差异有统计学意义(χ~2=10.693,P=0.001)。胃窦胃体萎缩患者的Hp感染率为90.00%,高于单纯胃窦萎缩患者的65.91%,差异有统计学意义(χ~2=4.091,P=0.043)。慢性胃炎炎症程度、活动性以及肠化程度分级越高,Hp的感染率也升高。Hp感染患者血清IL-6、CRP、TNF-α水平均高于非Hp感染患者,差异有统计学意义(P<0.05)。CagA蛋白(+)患者血清胃泌素水平为(64.75±8.52)pg/ml,高于CagA蛋白(-)患者的(52.49±7.33)pg/ml,差异有统计学意义(t=11.148,P<0.001)。胃炎非Hp感染者血清胃泌素水平(50.38±4.21)pg/ml,低于胃炎Hp感染CagA蛋白(+)组,差异有统计学意义(t=12.553,P<0.001)。结论 Hp感染与慢性胃炎的炎症程度、活动性和肠化程度相关;CagA蛋白(+)Hp感染可能通过促进患者血清炎症因子及胃泌素水平参与慢性胃炎患者胃黏膜一系列病理改变的发生和进展过程。OBJECTIVE To investigate the relationship between Helicobacter pylori(Hp) infection and serum inflammatory factors, gastrin and pathological features in different parts of stomach, and to provide theoretical basis for the development of clinical prevention and treatment of chronic gastritis. METHODS A total of 92 patients with chronic gastritis in Zunyi First People’s Hospital from January 2016 to June 2018 were enrolled in this study. Sixty-four patients with chronic atrophic gastritis were divided into the observation group, and 28 patients with non-chronic atrophic gastritis were divided into the control group. Levels of serum interleukin-6(IL-6), C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), CagA protein and gastrin were detected by enzyme-linked immunosorbent assay(ELISA) and the correlation between Hp infection and gastrin level was also analyzed. The degree of inflammation, activity and the grading of intestinal metaplasia and Hp infection between the two groups of patients were compared. The correlation between Hp infection rate and pathological features of chronic gastritis was analyzed. RESULTS The degree of inflammatory reaction, activity and intestinal metaplasia in the observation group were significantly higher than that in the control group(P<0.05). The infection rate of Hp in the observation group was 71.88%, which was significantly higher than that in the control group(35.71%)(χ~2=10.693, P=0.001). The infection rate of Hp in patients with antral and gastric atrophy was 90.00%, significantly higher than that in patients with simple antral atrophy(65.91%)(χ~2=4.091, P=0.043). The higher the degree of inflammation, activity and the grading of intestinal metaplasia of chronic gastritis are, the higher the infection rate of Hp is. The serum levels of IL-6, CRP and TNF-alpha in the Hp infection group were significantly higher than that in the non-Hp infection group(P<0.05). The serum gastrin level in the CagA protein(+) group was(64.75±8.52) pg/ml, which was significantly higher than

关 键 词：幽门螺杆菌 胃炎 病理学 炎症因子 胃泌素 特征 相关性 

分 类 号：R573.3[医药卫生—消化系统]