不同分型Hp感染消化性溃疡患者血清IL-10、IL-17、TNF-α水平及临床意义

Clinical significance of serum levels of IL-10, IL-17 and TNF-α in patients with peptic ulcer infected by different Helicobacter pylori strains

目的观察不同分型Hp感染消化性溃疡(PU)患者血清白介素-10(IL-10)、白介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平,并探讨其在PU诊断和治疗中的临床意义。方法选择2015年6月至2016年12月湖南省人民医院马王堆院区消化内科收治的PU患者170例,采用ELISA法检测PU患者血清中IL-10、IL-17、TNF-α含量,免疫印迹法鉴定Hp基因型,对比分析IL-10、IL-17、TNF-α在不同分型Hp感染消化性溃疡及部位中的差异。结果在170例PU患者中,HpⅠ型97例(57.06%),HpⅡ型26例(15.29%),Hp阴性47例(27.65%)。HpⅠ型组患者血清中IL-10、IL-17和TNF-α水平分别为(32.35±8.64)pg/m L、(56.21±12.46)pg/m L、(44.36+11.28)pg/m L,明显高于HpⅡ型组的(21.17±7.21)pg/m L、(36.06±8.62)pg/m L、(30.23±8.10)pg/m L和Hp阴性组的(18.56±7.56)pg/m L、(22.34±7.5)pg/m L、(14.84±6.35)pg/m L,差异均有统计学意义(P<0.05);各基因型组胃溃疡、十二指肠溃疡和复合性溃疡患者血清中IL-10水平比较差异均无统计学意义(P>0.05);各基因型组复合性溃疡血清中IL-17水平均明显高于胃溃疡和十二指肠溃疡,差异均有统计学意义(P<0.05);HpⅠ型组胃溃疡、十二指肠溃疡和复合性溃疡患者血清中TNF-α水平比较差异均有统计学意义(P<0.05)。结论不同分型Hp感染PU患者血清中IL-10、IL-17和TNF-α水平具有一定的差异,有助于Hp分型鉴别据。

Objective To observe the serum levels of interleukin-10 （IL-10）, interleukin-17 （IL-17）, tumor necrosis factor-α （TNF-α） in patients with peptic ulcer infected by different Helicobacter pylori strains, and explore their clinical significance in the diagnosis and treatment of peptic ulcer （PU）. Methods A total of 170 PU patients, who admitted to Department of Gastroenterology of Mawangdui Hospital of Hunan Provincial People＆#39;s Hospital from June 2015 to December 2016, were selected as the research subjects. The serum levels of IL-10, IL-17 and TNF-αof patients were detected by ELISA, and different Helicobacter pylori strains were detected by Western blot. Then the differences of IL-10, IL-17 and TNF-αamong different Helicobacter pylori strains and types were comparatively an-alyzed. Results Among 170 PU patients, 97 cases of typeⅠwas found detected by Western blot （57.06%）, as well as 26 cases of typeⅡ（15.29%）, and 47 cases of Helicobacter pylori negative （27.65%）. The serum levels of IL-10, IL-17 and TNF-αin Helicobacter pylori typeⅠgroup were （32.35±8.64） pg/mL, （56.21±12.46） pg/mL, （44.36＋11.28） pg/mL, re-spectively, which were significantly higher than （21.17±7.21） pg/mL, （36.06±8.62） pg/mL, （30.23±8.10） pg/mL in Heli-cobacter pylori typeⅡgroup and （18.56 ± 7.56） pg/mL, （22.34 ± 7.5） pg/mL, （14.84 ± 6.35） pg/mL in Helicobacter pylori negative group （P〈0.05）. There was no significant difference in the serum levels of IL-10 of gastric ulcer, duodenal ul-cer and compound ulcer in each genotype groups （P〉0.05）. The serum levels of IL-17 in compound ulcer were signifi-cantly higher in patients with gastric ulcer and duodenal ulcer （P〈0.05）. There was significant difference in serum levels of TNF-αbetween the patients of gastric ulcer, duodenal ulcer and compound ulcer infected by Helicobacter pylori typeⅠ（P〈0.05）. Conclusion There are significant difference in serum levels of IL-10, IL-17 and TNF-αof PU patients in-fected by different Helicobacter pylori strains, the detection of these items may help identify Helicobacter pylori genotypes, and provide reference for the diagnosis and treatment of diseases.