消化性溃疡患者Hp、胃粘膜炎症和血清胃液EGF变量的关系

Effect of EGF on peptic ulcer: relationship between H.pylori and gastric mucosal inflammation

目的探讨Ｈｐ感染对ＥＧＦ促进溃疡愈合作用的影响，以及ＥＧＦ含量与胃粘膜炎性变量之间是否存在着相互作用的关系．方法经内镜、组织学和尿素酶检测确诊的ＰＵ患者５６例，Ｈｐ（－）１８例，Ｈｐ（＋）３８例，上述患者均接受抗溃疡治疗，Ｈｐ（＋）者同时给予抗生素．治疗前后留取胃液、血清及胃窦粘膜组织，分别测定其ＥＧＦ，Ｈｐ及胃粘膜炎性变化情况．结果Ｈｐ（－）组：治疗前急、慢性炎症之间血清及胃液ＥＧＦ含量无显著性差异，治疗后胃液、血清ＥＧＦ上升，较治疗前有显著差异（胃液／血清μｇ／Ｌ４１９±６０，８７８±５０／６６３±８７，１６１６±１１３；Ｐ＜００５）．Ｈｐ（＋）组：３８例中Ｈｐ根除３２（８４２％）例，Ｈｐ清除复发６（１５８％）例．治疗前血清ＥＧＦ在伴有急、慢性炎症之间差异显著（８１８±７８；４０７±４９；Ｐ＜００５）；Ｈｐ根除者随着胃粘膜炎性病变好转，胃液、血清ＥＧＦ含量有不同程度上升，但与Ｈｐ复发者和Ｈｐ（－）组相比，胃液、血清ＥＧＦ之间并无显著性差异．慢性炎症者无论Ｈｐ（－）或（＋），治疗后的胃液ＥＧＦ虽有上升，但与治疗前相比，也无统计学意义．而Ｈｐ（＋）组伴发慢性炎症患者治疗前后的胃液、血清ＥＧＦ含量均较?

AIM To study the effect of EGF on promoting ulcer healing, and the relationship between Hp and the gastric mucosal histology. METHODS Mucosal histology and Hp urease test were performed in 56 male patients with PU diagnosed by endoscopy, including 18 patients of Hp(-) and 38 of Hp(+). All patients were treated with anti ulcer therapy. EGF of gastric juice and serum, Hp and gastric mucosal inflammation were measured before and after treatment. RESULTS In Hp(-) group (n=18) EGF concentrations both in gastric juice and serum had no difference before treatment between acute and chronic inflammation, whereas both levels of EGF increased significantly after treatment (gastric juice/serum μg/L 419±60 vs 878±50/663±87 vs 1616±113, P <0 05);In Hp(+) group Hp was eradicated in 32 of 38 (84 2%) and relapsed in 6(15 8%). There was difference in serum EGF between acute and chronic gastric mucosal inflammation before triple anti Hp therapy (818±78 vs 407±49, P <0 05). With significant improvement in inflammation, the gastric and serum EGF was gradually increased in patients in whom Hp was eradicated, but there were no statistical differences between Hp relapse and H.pylori (-) patients. In chronic inflammation patients with neither Hp(-) nor (+), the EGF levels in gastric juice had no difference after treatment. Both EGF levels in serum and gastric juice in Hp(+) cases were lower than those in Hp(-) subjects before and after treatment, and serum EGF decreased in chronic gastric inflammation significantly (652±126 vs 407±49, P <0 05) . CONCLUSION EGF in promoting ulcer healing appears to be not affected by Hp infection, whereas is relevant to the degree of gastric mucosal inflammation. Gastric juice EGF can not turn to normal in short time, because chronic gastric inflammation exists continuously. It may be the reason why EFG contents in gastric juice can not increase in patients with PU after treatment.