自然杀伤T细胞在幽门螺旋杆菌阳性消化性溃疡患者中的水平与临床意义

Clinical significance of natural killer T cells level in peptic ulcer patients with Helicobacter pylori infection

目的探讨幽门螺旋杆菌(Hp)阳性消化性溃疡患者(PU)外周血自然杀伤T细胞(NKT)的表达与临床意义。方法选择83例Hp阳性PU患者(A组),以79例Hp阴性PU患者作为阳性对照(B组),以60例健康人作为阴性对照(C组);采用流式细胞术检测A、B及C三组外周血NKT及其胞内细胞因子γ-干扰素(IFN-γ)及白介素4(IL-4)水平。将A组患者随机分为D及E组,两组均给予雷贝拉唑及甲硝唑治疗,D组在此基础上给予克拉霉素治疗,E组给予阿莫西林治疗,两周后进行NKT、IFN-γ及IL-4的水平比较,并将3种指标与治疗前Hp感染的程度进行相关性分析。结果 B与C组间的NKT及IFN-γ差异均无统计学意义,但A组NKT及IFN-γ水平低于B及C组,差异有统计学意义(P<0.05)。A组IL-4低于B组,且B组低于C组,差异有统计学意义(P<0.05)。治疗前D及E组间的NKT、IFN-γ及IL-4差异均无统计学意义(P>0.05),治疗后D组3种指标均显著高于E组(P<0.05)。Spearman分析显示NKT、IFN-γ及IL-4均与Hp感染程度呈负相关。结论 NKT、IFN-γ及IL-4水平下降导致杀伤力降低可能原因为Hp感染致PU的免疫机制破坏,且感染越重三者水平越低;克拉霉素在上调NKT、IFN-γ及IL-4的表达效果优于阿莫西林。

Objective To study the expression and clinical significance of natural killer T cells（NKT）in peptic ulcer（PU）patients with Helicobacter pylori（Hp）infection.Methods Eighty three PU patients with Hp were selected as group A,79 PU patients without Hp were selected as group B and 60 healthy people were selected as the group C.Using flow cytometry,levels of peripheral blood of NKT,intracellular cytokines gamma interferon（IFN-γ）and interleukin 4（IL-4）were detected and compared between group A,B and C.Patients in group A were randomly divided into D and E,and the two groups were both given rabeprazole and metronidazole.In addition,group D added clarithromycin treatment,and group E added amoxicillin.After two weeks,levels of NKT,IFN-γand IL-4were tested.Meanwhile,the relationship between three indicators and Hp infection degree was analysis.Results Levels of NKT and IFN-γbetween group B and C had no statistical difference,but the levels of NKT and IFN-γin group A were significantly lower than that of group B and C（P〈0.05）.IL-4in group A was significantly lower than that of group B,and which of group B was also significantly lower than that of group C（P〈0.05）.Levels of NKT,IFN-γand IL-4between group E and D before treatment had no statistical difference（P〈0.05）,while the three indicators in group D after treatment group were significantly higher than that of group E（P〈0.05）.Spearman correlation analysis showed that NKT,IFN-γand IL-4were negatively correlated with Hp infection degree.Conclusion The decrease of NKT,IFN-γand IL-4in cells may be the immune mechanism of PU patients with Hp infection,and the lower the levels of the three indicators,the more serious the infection.Effect of clarithromycin in up-regulation of expression of NKT,IFN-γand the IL-4is better than amoxicillin.