抗菌药物对幽门螺杆菌感染胃溃疡患者血清炎症因子及胃泌素指标的影响

Effect of omeprazole,amoxicillin and metronidazole on serum levels of inflammatory cytokines and gastric gastrin family indexes of patients with gastric ulcer of Hp infection

目的研究抗菌药物对幽门螺杆菌(Hp)感染胃溃疡患者相关临床指标的影响,为Hp感染胃溃疡患者的临床诊治提供参考依据。方法选取2010年10月-2013年12月收治的Hp感染胃溃疡患者84例,将其分为研究组和对照组,各42例,分别给予奥美拉唑、阿莫西林与甲硝唑三联治疗和单纯奥美拉唑治疗,对两组患者实施治疗前后的C-反应蛋白(CRP)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)等血清炎症因子和胃泌素(GAS)、胆囊收缩素(CCK)、胃动素(MTL)等胃泌素族指标以及两组患者治疗后的综合治疗效果和不良反应发生率进行观察和比较。结果研究组患者治疗后的CRP、IL-1和IL-6水平分别为(2.9±0.5)mg/dL、(18.3±5.4)ng/L和(44.3±9.5)ng/L,显著低于对照组患者的(6.0±1.2)mg/dL、(28.5±5.8)ng/L和(74.4±10.3)ng/L;研究组患者治疗后的GAS、CCK和MTL水平分别为(73.2±6.4)μmol/L、(13.5±2.4)pg/mL和(230.3±23.5)ng/L,显著优于对照组患者的(85.4±8.3)μmol/L、(16.0±4.3)pg/ml和(200.3±21.2)ng/L;研究组患者的治疗总有效率为95.2%,显著高于对照组患者的76.2%,研究组患者的不良反应发生率为2.4%,显著低于对照组患者的9.5%,且差异有统计学意义(P<0.05)。结论采用奥美拉唑、阿莫西林与甲硝唑联合治疗方法治疗Hp感染胃溃疡患者的临床优势明显,患者的血清炎症因子及胃液胃泌素族指标改善效果更佳,是临床治疗实践的理想选择方式。

OBJECTIVE To investigate the effects of the related clinical indicators of omeprazole,amoxicillin and metronidazole on patients with gastric ulcer of Hp infection so as to provide references for the clinical diagnosis and treatment of Hp infection.METHODS A total of 84 patients of gastric ulcer of Hp infection admitted to our hospital from Oct.2010 to Dec.2013 were chosen.They were divided into study group and control group,with 42 cases in each group.They were treated with omeprazole,amoxicillin and metronidazole triple therapy and omeprazole alone.The C-reactive protein（CRP）,interleukin-1（IL-1）,interleukin-6（IL-6）and other inflammatory cytokines and serum gastrin（GAS）,cholecystokinin（CCK）,motilin（MTL）and other gastrin family of indexes and comprehensive treatment and adverse reactions for the two groups before and after treatment were observed and compared.RESULTS The CRP,IL-1and IL-6levels in study group after treatment were（2.9±0.5）mg/dL,（18.3± 5.4）ng/L and（44.3± 9.5）ng/L,significantly lower than the those of control group of（6.0±1.2）mg/dL,（28.5±5.8）ng/L and（74.4±10.3）ng/L.The GAS,CCK and MTL levels in study group after treatment were（73.2±6.4）μmol/L,（13.5±2.4）pg/mL and（230.3±23.5）ng/L,significantly better than those of control group of（85.4±8.3）μmol/L,（16.0± 4.3）pg/ml and（200.3±21.2）ng/L.The total treatment effective rate in study group was 95.2%,significantly higher than 76.2% of control group.The rate of adverse reactions in study group was 2.4%,significantly lower than 9.5% of control group.CONCLUSION The clinical comparative advantages of omeprazole,amoxicillin and metronidazole combination therapy method for the treatment of gastric ulcer Hp infection is significant,the improvement of serum inflammatory factors and indicators of patients with gastric gastrin family is better,and it is the ideal way of clinical practice.