摘要
目的:探讨H pylori感染及根除对慢性糜烂性胃炎患者IL-18水平的影响,同时检测抗H pylori治疗前后抗体水平的变化.方法:60例上消化道患者分两组,慢性糜烂性胃炎组(实验组)40例,慢性浅表性胃炎组(对照组)20例.实验组H pylori阳性者予口服洛赛克20 mg和克拉霉素500 mg及阿莫西林1000 mg,1 wk后症状缓解者,开始口服洛赛克20 mg/d至4 wk实验结束,对照组仅口服洛赛克抗H pylori治疗,1 mo后复查^(13)C呼气实验和胃镜.H pylori免疫印迹法进行蛋白抗体分型,同时ELISA法检测H pylori-IgG,IL-18水平.结果:治疗前H pylori阳性者实验组血清IL-18水平高于对照组(267.18±148.23 ng/L vs 119.31±45.34 ng/L:P<0.05).抗H pylori治疗后慢性糜烂性胃炎患者的IL-18,抗体水平均有明显下降(267.18±148.23 ng/L vs 93.82±22.15 ng/L;31.36±23.26 kU/L vs 21.00±9.47 kU/L;P<0.05).H pylori感染类型及糜烂的严重程度与IL-18水平无明显的相关性.结论:抗H pylori治疗后IL-18水平的下降在慢性糜烂性胃炎糜烂的治疗过程中发挥重要作用.
AIM: To explore the effects of Helicobacter pylori infection and its eradication on Interleukin-18 (IL-18) level in patients with chronic erosive gastritis, and to detect levels of H pylori IgG antibody before and after eradication. METHODS: Sixty patients with chronic gastritis were randomly divided into two groups: chronic erosive gastritis (40 cases, group A) and chronic superficial gastritis (20 cases, group B). Group A patients who were H pylori-positive received triple therapy [20 mg omeprazole (Losec) plus 500 mg clarithromycin and 1000 mg amoxicilin, twice daily) for 1 week; while those positive for H pylori in group B were treated orally with only 20 mg omeprazole once daily until the end of week 4. Gastric endoscopy and ^13C breath testing were performed 1 mo after anti-H pylori therapy. CagA-IgG, VacA-IgG, Uresses-IgG and H pylori IgG antibody, IL-18 were detected by Western blotting and ELISA, respectively RESULTS: The levels of IL-18 were significantly different between groups A and B (267.18 ± 148.23 ng/L, and 119.31 ± 45.34 ng/L, P 〈 0.05) in H pylori-positive patients. H pylori IgG level was not related to the presence of erosion; with no significant difference between H pylori negative patients in groups A and group B. The levels of IL-18 and IgG antibody decreased after anti-H pylori therapy compared with those before therapy (267.18 ± 148.23 ng/L vs 93.82 ± 22.15 ng/L; 31.36 ± 23.26 kU/L vs 21.00 ± 9.47 kU/L; respectively, P 〈 0.05), IL-18 level showed no difference among different types of H pylori infection and erosion scores. CONCLUSION: The decrease in IL-18 level after H pylori eradication may play a crucial role in the treatment of patients with chronic erosive gastritis.
出处
《世界华人消化杂志》
CAS
北大核心
2007年第21期2306-2310,共5页
World Chinese Journal of Digestology