高原地区幽门螺杆菌相关溃疡血清白细胞介素-2和白细胞介素-4水平变化及意义

Significance of serum IL-2 and IL-4 of the patients with helicobacter pylori-related ulcer in highland area

目的测定青海地区幽门螺杆菌（Hp）相关溃疡患者血清白细胞介素-2（IL-2）和白细胞介素-4（IL-4）的水平，观察根除Hp治疗对其的影响，以探讨Hp在溃疡发病中的可能免疫致病机制，为临床治疗提供理论依据。方法应用放射免疫法测定55例（Hp感染30例，非Hp感染25例）溃疡患者血清IL-2和IL-4的含量，比较Hp感染与非感染患者其含量的差异，对Hp阳性者进行以洛赛克为中心的三联根除治疗，比较Hp根除前、后及Hp根除者和未根除者其含量的差异，同时比较Hp根除组和未根除组溃疡的愈合率。结果Hp感染者血清IL-4含量明显低于非感染者（P〈0．01），Hp根除后明显高于根除前（P〈0．001），Hp未根除者前后无变化（P〉0．05），Hp根除者明显高于未根除者（P〈0．05），Hp根除组溃疡愈合率明显高于Hp未根除组（P〈0．05）。而IL-2在Hp感染者与非感染者中差异无显著性（P〉0．05），根除Hp治疗对其亦无明显影响（P〉0．05）。结论Hp感染后IL-4分泌减少引起的TH2弱势应答为本地区Hp相关性溃疡发生的主要免疫致病机制，对Hp阳性的溃疡患者进行根除Hp治疗可调节优势免疫应答类型和TH1／TH2平衡，从而达到治疗疾病的目的。

Objective To detect the levels of serum IL-2 and IL-4 of the patients with helicobacter pylorirelated ulcer in Qinghai area and to observe the effect of Hp eradication on the mand explore the mechanism of Hp in ulcer. Methods IL-2 and IL-4 levels of 55 cases （30 cases of Hp infection and 25 cases of non-Hp infection） were detected by radioimmunity assay. The differences of IL-2 and IL-4 between the Hp-infection group and non-Hp infection group were compared. Hp was eradicated in the Hp positive patients by Luosange-centered therapy and then the levels of IL-2 and IL-4 were compared in the patients with Hp eradication and without Hp eradiation, meanwhile the curing rate of ulcer in the two groups was analyzed. Results IL-4 levels in Hp-infection group were obviously lower than that in non-Hp infection group （P 〈 0.01）, which was obviously increased after eradication （P 〈 0.001） but did not change in the patients without Hp eradication （P 〉 0.05）, which was obviously higher in Hp eradication group than that in group without Hp eradication （P 〈 0.05） and the curing rate of ulcer was obviously higher in Hp eradication group than in group without Hp eradication （P 〈 0.05）. IL-2 was not significantly changed both in the patients with Hp infection and without Hp infection （P 〉 0.05）. Condusion The main immunity mechanism of Hp-associated ulcer is the weak response of TH2 caused by the decreased secretion of IL-4 after Hp infection, so Hp eradication for the Hp positive patients with ulcer will regulate the immune response type and TH1/TH2 balance.