消化内镜止血联合生长抑素与艾普拉唑治疗十二指肠溃疡出血对胃促生长素和胃动素及Th1/Th2细胞因子的影响  

Effects of digestive endoscopic hemostasis combined with somatostatin and ilaprazole on ghrelin and motilin and Th1/Th2 cytokines in treatment of duodenal ulcer bleeding

作　　者：樊和明[1] 谷渊 FAN He-ming;GU Yuan(Department of Gastroenterology,Xinxiang the First People's Hospital,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市第一人民医院消化内科,河南新乡453000

出　　处：《医药论坛杂志》2025年第1期95-99,共5页Journal of Medical Forum

摘　　要：目的探讨在十二指肠溃疡出血中,消化内镜止血联合生长抑素与艾普拉唑对血清胃促生长素、胃动素及血清辅助性T细胞1/辅助性T细胞2(T helper 1 cell/T helper 2 cell,Th1/Th2)细胞因子的影响。方法按随机数字表法,将新乡市第一人民医院2022年10月至2024年10月确诊为十二指肠溃疡出血的患者182例分为观察组和对照组,各91例。两组均予以基础治疗,对照组单独使用艾普拉唑治疗,观察组在对照组基础之上联合生长抑素进行消化内镜止血治疗,对两组患者的临床疗效进行评价,测定两组治疗前后的血清胃动素、胃促生长素和Th1/Th2细胞因子水平,以及凝血酶原时间(prothrombin time,PT)、部分活化凝血酶原时间(activated prothrombin time,APTT)、纤维蛋白原(fibrinogen,Fib)凝血指标,观察治疗期间两组不良反应发生率。结果两组有效率差异显著,观察组为92.31%(84/91),对照组为80.22%(73/91),两组差异有统计学意义(P<0.05);疗程结束后,两组血清胃促生长素和血清胃动素水平均上升,且观察组升高更多,差异有统计学意义(P<0.05);两组PT、APTT水平均降低,FIB水平均升高,差异有统计学意义(P<0.05),且观察组PT、APTT水平下降更多,差异有统计学意义(P<0.05),FIB水平升高更多,差异有统计学意义(P<0.05);两组干扰素-γ(iinterferon-γ,IFN-γ)、白细胞介素-2(interleukin-2,IL-2)、水平均降低,白细胞介素-4(interleukin-4,IL-4)、白细胞介素-5(interleukin-5,IL-5)水平均升高,差异有统计学意义(P<0.05),且观察组IFN-γ、IL-2水平下降更多,差异有统计学意义(P<0.05),IL-4、IL-5水平升高更多,差异有统计学意义(P<0.05);两组不良反应发生率差异无统计学意义(P<0.05)。结论消化内镜止血联合生长抑素与艾普拉唑治疗十二指肠溃疡出血效果显著,有效提升患者血清胃促生长素、胃动素水平,改善胃肠动力,促进其饮食。能明显提升血液凝固能力,减少出血部位止Objective To investigate the effect of endoscopic hemostasis combined with somatostatin and ilaprazole on ghrelin,motilin and T helper 1 cell/T helper 2 cell(Th1/Th2)cytokines in the treatment of duodenal ulcer bleeding.Methods Totally 182 patients diagnosed with duodenal ulcer bleeding in the Xinxiang First People's Hospital from October 2022 to October 2024 were divided into observation group and control group with 91 cases each.The two groups were given basic treatment,the control group was treated with ilaprazole alone,and the observation group was treated with endoscopic hemostasis combined with somatostatin on the basis of the control group,The levels of serum motilin,ghrelin and Th1/Th2 cytokines were measured by enzyme-linked immunosorbent assay(ELISA)before and after treatment,and the levels of prothrombin time(PT),partially activated prothrombin time(APTT)before and after treatment were measured by noninvasive hemodynamic analyzer fibrinogen(FIB)coagulation indicators were detected,and the adverse reactions of the two groups.Results There was a wide difference in efficacy between the two groups,which was 92.31%(84/91)in the observation group and 80.22%(73/91)in the control group,there was a statistically significant difference between the two groups(P<0.05);after the end of treatment,the serum levels of ghrelin and motilin increased in the two groups,and the levels of ghrelin and motilin in the observation group increased more,the difference was statistically significant(P<0.05);after treatment,the levels of PT and APTT decreased in the two groups,the levels of FIB increased,the difference was statistically significant(P<0.05),and the levels of PT and APTT decreased more in the observation group,the difference was statistically significant(P<0.05),the level of FIB increased more,the difference was statistically significant(P<0.05);the levels of interferon-γ(IFN-γ)and interleukin-2(IL-2)decreased and the levels of interleukin-4(IL-4)and interleukin-5(IL-5)were higher than that before treatment,the diff

关 键 词：消化内镜 生长抑素 艾普拉唑 十二指肠溃疡出血 胃促生长素 胃动素 辅助性T细胞1/辅助性T细胞2 

分 类 号：R573.1[医药卫生—消化系统]