hp阳性慢性萎缩性胃炎患者血清ROS、IL-33水平与四联疗法hp根除率的关系  

Relationship between serum reactive oxygen species(ROS),interleukin-33(IL-33)levels and helicobacter pylori(hp)eradication rate in patients with hp-positive chronic atrophic gastritis(CAG)

作　　者：江永强 韩海静 苏红霞 李转 屈耀宁 党飞 郝亚茹 崔亚玲 王春莹 JIANG Yongqiang;HAN Haijing;SU Hongxia;LI Zhuan;QU Yaoning;DANG Fei;HAO Yaru;CUI Yaling;WANG Chunying(Department of Gastroenterology,General Hospital of Ordnance Industry,Xi'an 710065,China;Endoscopy Room,General Hospital of Ordnance Industry,Xi'an 710065,China)

机构地区：[1]兵器工业总医院消化内二科,西安710065 [2]兵器工业总医院内镜室,西安710065

出　　处：《新疆医科大学学报》2025年第3期305-310,316,共7页Journal of Xinjiang Medical University

基　　金：陕西省卫生健康科研基金项目(2022D062)。

摘　　要：目的探讨幽门螺杆菌(hp)阳性慢性萎缩性胃炎(CAG)患者血清活性氧(ROS)、白细胞介素33(IL-33)水平与四联疗法hp根除率的关系。方法选取2022年1月至2024年8月本院收治的hp阳性CAG患者218例,均实施四联疗法治疗14 d,统计hp根除率。将hp未根除者纳入观察组,hp根除者纳入对照组。两组均在治疗前检测血清ROS、IL-33水平。分析血清ROS、IL-33水平与hp阳性CAG患者hp根除率的关系及预测价值。结果218例hp阳性CAG患者四联疗法治疗14 d后hp根除率为80.73%(176/218)。hp未根除者42例纳入观察组,hp根除者176例纳入对照组。两组治疗前血清ROS、IL-33水平比较,观察组高于对照组(P<0.05)。治疗依从性、阿莫西林耐药、克拉霉素耐药、hp类型、ROS、IL-33为hp阳性CAG患者hp根除率的独立影响因素(P<0.05)。无论是否调整混杂因素,ROS、IL-33水平升高均会增加hp阳性CAG患者hp根除失败风险。血清ROS、IL-33水平预测hp阳性CAG患者hp根除率的AUC值分别为0.774,0.790,二者联合预测的AUC值为0.860。血清ROS、IL-33联合预测hp阳性CAG患者hp根除率的AUC值大于单一指标的预测值(P<0.05)。结论血清ROS、IL-33高水平是hp阳性CAG患者四联疗法hp根除失败的独立危险因素,通过检测二者血清水平可判定患者hp根除失败风险,对患者治疗方案的制定及调整有一定指导意义。Objective To investigate the relationship between blood reactive oxygen species(ROS)and interleukin-33(IL-33)levels and helicobacter pylori(hp)eradication rate in patients with hp positive chronic atrophic gastritis(CAG).Methods A total of 218 patients with hp-positive CAG in the hospital from January 2022 to August 2024 were selected,all of whom were treated with quadruple therapy for 14 days,and the hp eradication rate was analyzed.hp non-eradicated subjects were included in observation group and hp eradicated subjects were included in control group.Serum ROS and IL-33 levels were detected in both groups before the treatment.The relationship and predictive value of serum ROS,IL-33 levels and hp eradication rate in hp-positive CAG patients were analyzed.Results The eradication rate of hp in 218 patients with hp-positive CAG after 14 days of quadruple therapy was 80.73%(176/218).42 cases of hp not eradicated were included in the observation group and 176 cases of hp eradicated were included in the control group.Before the treatment,the levels of serum ROS and IL-33 in the observation group were higher than those in the control group(P<0.05).Treatment compliance,amoxicillin resistance,clarithromycin resistance,hp type,ROS and IL-33 were independent influencing factors of hp eradication rate in hp-positive CAG patients(P<0.05).Regardless of adjusting for confounders,ROS and IL-33 levels were increased the risk of hp eradication failure in hp-positive CAG patients.Serum ROS and IL-33 levels predicted the hp eradication rate in hp-positive CAG patients with an AUC value of 0.774 and 0.790,respectively,and the AUC value of the combined prediction was 0.860.The AUC value of serum ROS and IL-33 combined predicted hp eradication rate in hp-positive CAG patients was greater than the predicted value of a single indicator(P<0.05).Conclusion High levels of serum ROS and IL-33 are independent risk factors for the failure of hp eradication with quadruple therapy in hp-positive CAG patients.Detection of their serum levels can d

关 键 词：幽门螺杆菌阳性 慢性萎缩性胃炎 四联疗法 活性氧 白细胞介素33 

分 类 号：R573.3[医药卫生—消化系统]