胃溃疡发生和愈合中细胞免疫功能的变化

The changes of cellular immunity in the pathogenesis and healing of gastric ulcer

目的:探讨细胞免疫功能在胃溃疡(GU)发生和愈合中的变化。方法:胃镜及病理证实的GU患者26例。在西咪替丁(1g/d〕治疗5—8周前后测定外周血T细胞亚群(APAAP桥联酶标法)及NK细胞活性(LDH释放法〕。20例健康人作为对照。结果:活动期GU患者CD_3^+,CD_4^+,CD_4^+/CD_8^+比值及NK细胞活性分别为(55.1％±6.4％,41.4％±5.2％,1.69±0.24和29.7％±6.0％)明显低于正常人(P<0.05)。随着西咪替丁治疗使溃疡愈合,上述指标较用药前明显升高(分别为58.8%±6.8%,43.2％±5.0％,1.79±0.33和34.2％±5.9％,P<0.05),与正常人相似(P>0.05)。CD_8^+治疗后(25.0％±7.1%)较治疗前(25.5％±6.8％)无明显变化(P>0.05)。结论:细胞免疫功能在GU的发生和愈合中有一定变化。除抑制胃酸外,西味替丁还能影响机体的免疫功能而治疗GU。

AIM The changes of cellular immunity in the pathogenesis and healing of gastric ulcer were studied.METHODS Peripheral blood T lymphocyte subsets and natural killer cell activity)NKCA)were measured respectively bymonoclonal antibody method)APAAP)and LDH-release method before and after)1 g/day for 5-8 weeks)cimetidinetreatment in 26 patients with gastric ulcer proved by endoscopy and pathology.Twenty healthy persons were also studied ascontrols.RESULTS Compared with the control group)n=20),CD3+,CD+\-4,CD4+/CD8+ and NKCA)55.1%±6.4%,41.4%±5.2%,1.69±0.24 and 29.7% ±6.0% respectively)of patients with active gastric ulcer before treatment weresignificantly decreased)P<0.05).and CD8+)25.5%±6.8%)had an increasing tendency,but there was no significantdifference)P<0.05).After 5-8 weeks treatment with cimetidine 1 g/d,CD3+.CD4+,CDa4+/ CDs and NKCA)58.5%±6.8%,43.19±5.0%,1.79±0.33 and 34.2% ±5.9% respectively)were significantly increased)P<0.05),CD8+(25.0%±7.1%)had a decreasing tendency)P>0.05)compared with the same patients before treatment.CONCLUSION The cellular immunity of patients with active gastric ulcer is decreased.Except for the known mechanism,cimetidine may modulate immunity to cure ulcer.