泮托拉唑联合克拉霉素对幽门螺杆菌感染患者MMP-2和MMP-3表达的影响  

Effect of pantoprazole combined with clarithromycin on the expression of MMP-2 and MMP-3 in patients with Helicobacter pylori infection

作　　者：李欣 徐丽丽 孙丹 王琳 LI Xin;XU Li-li;SUN Dan;WANG Lin(Qingdao Hospital of Traditional Chinese Medicine(Qingdao Hiser Hospital),Qingdao,Shandong 266033,China)

机构地区：[1]青岛市海慈医疗集团保健办,山东青岛266033 [2]青岛市海慈医疗集团血管外科,山东青岛266033 [3]青岛市海慈医疗集团泌尿外科,山东青岛266033 [4]青岛市海慈医疗集团肝胆内科,山东青岛266033

出　　处：《中华医院感染学杂志》2020年第3期383-387,共5页Chinese Journal of Nosocomiology

基　　金：山东省科技计划基金资助项目(ZDXM20180050)。

摘　　要：目的探讨泮托拉唑联合克拉霉素在幽门螺杆菌(Helicobacter pylori,Hp)感染患者中的临床效果及对基质金属蛋白酶-2((Matrix metalloproteinase-2,MMP-2)、MMP-3表达水平的影响。方法选择2016年6月-2018年4月于青岛市海慈医疗集团治疗的Hp感染患者74例为研究对象,随机分为对照组和研究组,各37例。对照组给予传统三联疗法(奥美拉唑、阿莫西林、呋喃唑酮)治疗,研究组采用泮托拉唑、阿莫西林及克拉霉素治疗,比较两组治疗1、2、3、4周时的Hp清除率,治疗后4周对患者治疗效果进行评估,比较两组Hp清除率、炎症因子[C-反应蛋白(CRP)、白细胞介素-1(IL-1)和IL-6水平]、胃泌素(Gastrin,GAS)、MMP-2、MMP-3水平和药物安全性评价。结果治疗后3周、4周研究组Hp清除率为89.19%(33/37)、94.59%(35/37)与对照组比较差异无统计学意义;研究组治疗后1周、2周Hp清除率分别为72.97%(27/37)、86.49%(32/37)高于对照组(P<0.05);研究组治疗后4周CRP、IL-1、IL-6及GAS分别为(2.83±0.41)mg/ml、(18.68±3.12)ng/ml、(44.23±3.41)ng/ml及(71.21±4.39)ng/ml均低于对照组(P<0.05);治疗后4周,研究组MMP-2、MMP-3分别为(132.56±3.09)μg/L、(154.67±5.78)μg/L均低于对照组(P<0.05);研究组不良反应发生率为5.41%(2/37)低于对照组21.62%(8/37)(P=0.041)。结论泮托拉唑联合克拉霉素用于幽门螺杆菌感染患者的治疗有助于提高Hp早期清除率,降低炎症因子水平,能改善MMP-2、MMP-3水平,且未增加药物不良反应,具有一定的临床价值。OBJECTIVE To investigate influence of pantoprazole combined with clarithromycin on the clinical effect and the expression of matrix metalloproteinase-2,3(MMP-2,MMP-3)in patients with Helicobacter pylori(Hp)infection.METHODS A total of 74 patients with Hp infection were enrolled and radomized into control group(n=37)and observation group(n=37)in Qingdao Hiser Medical Association from Jun.2016 to Apr.2018.The control group was treated with traditional triple therapy(omeprazole,amoxicillin,furazolidone),while the observation group was treated with pantoprazole,amoxicillin and clarithromycin.The Hp clearance between two groups were compared at 1,2,3 and 4 weeks after treatment,respectively.The treatent effect,including Hp clearance,inflammatory factors(C-reactive protein(CRP),interleukin-1(IL-1)and interleukin-6(IL-6)levels),gastrin(GAS),MMP-2,MMP-3 level and drug safetywere,were compared between two groups at 4 weeks after treatment.RESULTS The Hp clearance rae in observation group at 3 and 4 weeks was 89.19%(33/37)and 94.59%(35/37),respectively,with no significant difference compared with that of control group.The Hp clearance rate in observation group at 1 week and 2 weeks after treatment was 72.97%(27/37)and 86.49%(32/37),respectively,which was significantly higher than that in control group(P<0.05).The levels of CRP,IL-1,IL-6 and GAS in the observation group were(2.83±0.41)mg/ml,(18.68±3.12)ng/ml,(44.23±3.41 ng/ml and(71.21±4.39),respectively,which were significantly lower than those in the control group at 4 weeks after treatment(P<0.05).The levels of MMP-2 and MMP-3 in the observation group 4 weeks after treatment were(132.56±3.09)μg/L and(154.67±5.78)μg/L,respectively,which were significantly lower than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was 5.41%(2/37),which was significantly lower than that in the control group(21.62%,8/37)(P=0.041).CONCLUSION Pantoprazole combined with clarithromycin can improve Hp clearance in early stage,reduce inflammato

关 键 词：泮托拉唑 克拉霉素 幽门螺杆菌 基质金属蛋白酶 Hp清除率 炎症因子 不良反应 

分 类 号：R378[医药卫生—病原生物学]