H pylori感染及根除对慢性糜烂性胃炎患者IL-18水平的影响

Effects of Helicobacter pylori infection and its eradication on IL-18 level in chronic erosive gastritis patients

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.