兰索拉唑对Hp引起糜烂性胃炎患者Th1/Th2漂移的影响

Effect of Lansoprazole Treatment on Hp Induced Th1/Th2 Drift in Patients with Erosive Gastritis

目的探讨口服兰索拉唑对Hp引起糜烂性胃炎患者Th1/Th2漂移的影响。方法将我科诊断为糜烂性胃炎的92例患者作为研究对象,分为两组。将46例合并Hp感染者为实验组,另外46例Hp阴性者设为对照组,两组均给予兰索拉唑肠溶胶囊;实验组加用克拉霉素及阿莫西林抗Hp治疗;治疗后检查Hp;检测并收集患者治疗前、后血清样本,应用ELISA方法检测IFN-γ、IL-4水平。结果治疗1月后两组患者Hp检测均为阴性;治疗前实验组IFN-γ、IL-4及IFN-γ/IL-4均显著低于对照组(P<0.05);治疗后两组IFN-γ、IL-4及IFN-γ/IL-4差异均无统计学意义(P>0.05)。实验组与对照组总有效率分别为93.5%、82.6%,差异无统计学意义(P>0.05)。两组患者均无严重并发症发生。结论 Hp感染可致糜烂性胃炎患者血清IFN-γ、IL-4水平降低,Th1向Th2细胞漂移;兰索拉唑可逆转Hp致病患者血清IFN-γ、IL-4水平降低,逆转Th1向Th2细胞漂移效应。

Objective To explore the effect of oral administration of lansoprazole on Helicobacter pylori（Hp） induced Th1/Th2 drift in patients with erosive gastritis. Methods 92 patients with erosive gastritis were enrolled, including 46 patients complicated with Hp infection（experiment group） and 46 patients with no Hp infection（control group）; oral administration of lansoprazole enteric-coated capsules was made to patients in both groups while anti-Hp treatment with clarithromycin and amoxicillin was added to patients in experiment group; after treatment, detection of Hp was made; the serum samples of the patients before and after treatment were collected and ELISA was applied in detecting IFN-γ and IL-4 levels. Results 1 month after treatment, Hp of all the patients in both groups was negative; before treatment, IFN-γ and IL-4 levels of the patients in experiment group were much lower than those of the patients in control group（P0.05） while after treatment there existed no statistical difference in IFN-γ and IL-4 levels between the 2 groups（P0.05）; the total effective rate of experiment group was 93.5% while that of control group was 82.6%, the difference was of no statistical significance（P0.05）. Conclusions Hp infection can cause the inhibition of serum IFN-γ and IL-4 levels, inducing the Th1 cells to Th2 immune imbalance drift. The lansoprazole treatment can reverse the Hp induced Th1/Th2 immune imbalance in patients with erosive gastritis, which is worthy of clinical application.