替普瑞酮改良四联疗法对Hp毒力基因与HGF/c-Met信号通路的影响  

Effects of Teprenone Modified Quadruple Therapy on Hp Virulence Gene and HGF/c-Met Signaling Pathway

作　　者：曾福生 ZENG Fusheng(Department of Gastroenterology,the Second Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330012,China)

机构地区：[1]江西中医药大学第二附属医院消化科,江西南昌330012

出　　处：《中国医学创新》2024年第23期23-27,共5页Medical Innovation of China

基　　金：江西省卫生计生委中医药科研课题(2018B059)。

摘　　要：目的:探究替普瑞酮改良四联疗法治疗幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的效果,以及对Hp毒力基因表达与血清肝细胞生长因子/肝细胞生长因子受体(HGF/c-Met)信号通路的影响。方法:选取江西中医药大学第二附属医院2021年7月—2023年6月收治的114例Hp阳性CAG患者作为研究对象,随机分为对照组(n=57)和观察组(n=57),对照组采取常规铋剂四联疗法,观察组使用替普瑞酮改良四联疗法,观察两组患者的疗效、Hp根除率、Hp复发率、不良反应、Hp毒力因子[细胞毒素相关蛋白(CagA)、空泡细胞毒素(VacA)]、血清HGF和胃黏膜HGF、c-Met表达水平。结果:观察组总有效率、Hp根除率均较对照组高,Hp复发率较对照组低,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,观察组Hp毒力因子CagA、VacA阳性率均较对照组低(P<0.05)。治疗后,观察组血清HGF和胃黏膜HGF、c-Met表达水平均较对照组低,差异均有统计学意义(P<0.05)。结论:替普瑞酮改良四联疗法治疗Hp阳性CAG患者可显著降低患者CagA、VacA阳性率及HGF、c-Met表达水平,疗效优于铋剂四联疗法,且不会增加安全风险。Objective:To investigate the efficacy of Teprenone modified quadruple therapy in the treatment of Helicobacter pylori(Hp)positive chronic atrophic gastritis(CAG)and its effect on the expression of Hp virulence genes and serum hepatocyte growth factor/hepatocyte growth factor receptor(HGF/c-Met)signaling pathway.Method:A total of 114 patients with Hp positive CAG admitted to the Second Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from July 2021 to June 2023 were selected as the research objects,they were randomly divided into control group(n=57)and observation group(n=57).The control group was treated with conventional bismuth quadruple therapy,and the observation group was treated with Teprenone modified quadruple therapy.The efficacy,Hp eradication rate,Hp recurrence rate,adverse reactions,Hp virulence factors[cytotoxin-associated protein(CagA),vacuolated cytotoxin(VacA)],serum HGF and gastric mucosal HGF,c-Met expression levels were observed in the two groups.Result:The total effective rate and eradication rate of Hp in the observation group were higher than those in the control group,and the recurrence rate of Hp was lower than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the positive rates of Hp virulence factors CagA and VacA in the observation group were lower than those in the control group(P<0.05).After treatment,the expression levels of HGF in serum and HGF and c-Met in gastric mucosa in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Teprenone modified quadruple therapy in the treatment of Hp positive CAG patients can significantly reduce the positive rates of CagA and VacA and the expression levels of HGF and c-Met,and has better efficacy than bismuth quadruple therapy without increasing safety risks.

关 键 词：替普瑞酮 慢性萎缩性胃炎 幽门螺杆菌 毒力基因 肝细胞生长因子 肝细胞生长因子受体 

分 类 号：R573.32[医药卫生—消化系统]