不同证候舌苔HSP70、IL-8 mRNA表达与胃黏膜HP感染和病理改变的关联

Correlation of mRNA expressions of HSP70 and IL-8 in coating on tongue,HP infection and pathological changes of gastric mucosa in patients with different TCM patterns

目的探讨幽门螺旋杆菌（HP）相关胃病不同证候胃黏膜HP感染、病理改变与舌苔热休克蛋白70（HSP70）、白细胞介素-8（IL-8）mRNA表达的关联。方法收集2010年3~11月就诊于广州中医药大学第一附属医院HP相关胃病患者96例（慢性胃炎72例、消化性溃疡24例;脾胃湿热证68例、脾气虚证28例）,招募健康志愿者14名作为正常对照;分别采用快速尿素酶、美蓝及HE染色进行胃黏膜HP感染和病理检测;荧光定量PCR检测舌苔HSP70、IL-8 mRNA表达。结果脾胃湿热证HP感染率较脾气虚证高,感染程度则以脾气虚证较为明显;脾气虚证炎症程度、活动性重于脾胃湿热证;同一证候HP感染者炎症程度、活动性明显高于非感染者（P〈0.01）;脾胃湿热和脾气虚证HP感染者胃黏膜淋巴滤泡、萎缩伴肠化生和/或异型增生病理改变明显高于非HP感染者。HP感染者舌苔HSP70、IL-8 mRNA表达高于非感染者,HP感染越重IL-8表达越明显;脾胃湿热证HSP70表达低于脾气虚证,但IL-8表达高于脾气虚证;HP感染脾气虚证HSP70表达较非HP感染脾胃湿热、脾气虚证明显增高（P〈0.05）。结论舌苔HSP70、IL-8 mRNA表达与胃黏膜HP感染及炎症、萎缩伴肠化生和/或异型增生病理改变相关,呈现不同证候差异表达特征,研究结果为HP相关胃病客观辨证提供了一定的参考依据。

Objective Taking patients with Helicobacter pylori（ HP）-related gatrosis as the subjects,so as to study correlation of TCM patterns,HP infection,pathological changes of gastric mucosa and mRNA expression of heat shock protein70（ HSP 70） and interleukin-8（ IL-8）. Methods In the First Affiliated Hospital of Guangzhou University of Chinese Medicine,total 96 patients with HP-related gastrosis were included from March to November in 2010,including 72 cases of chronic gastritis and 24 cases of peptic ulcer,with 68 cases of splenogastric hygropyrexia pattern（ SGHP） and 28 cases of spleen deficien-cy pattern（ SDP）,and 14 healthy volunteers recruited were assigned into control group. Using rapid urease test,methylene blue test and HE staining to detect HP infection and gastric mucosa pathological changes; using fluorescence quantitative PCR to detect mRNA expression of HSP70 and IL-8 of tongue coating. Results HP infection rate in SGHP was higher than that in SDP,while more severe and more active than the latter; HP infection in patients was more severe and active than that of subjects without HP infection with the same TCM pattern（ P〈0. 01）. The gastric mucosal lymphoid follicles,atrophy with intestinal metaplasia and/or hyperplasia pathological changes due to HP infection were significantly higher than no-infected subjects in SGHP and SDP. HSP70,IL-8 mRNA expressions of patients were higher than no-infected ones in tongue coating. More severe HP infection was,more IL-8 mRNA expressed. HSP70 mRNA expression in SGHP was lower than SDP,but IL-8 expression was higher. HSP70 expression of HP infected patients with SDP was significantly higher than no-infected people with SGHP and SDP（ P〈0. 05）. Conclusion The correlation of HSP70,IL-8 mRNA expression in tongue coating,HP infected gastric mucosa and atrophy with intestinal metaplasia and/or hyperplasia pathological changes was proved,which showed specific features with TCM patterns. The results would provide reference to pattern differentiation for HP-related gastrosis.