埃索美拉唑四联方案治疗胃溃疡的临床疗效与患者的外周血T细胞亚群水平的关联性分析

Analysis of the clinical efficacy of esomeprazole quadruple program in patients with gastric ulcer and its peripheral blood T lymphocyte subsets

为探讨外周血T细胞亚群水平对埃索美拉唑四联方案治疗胃溃疡临床疗效的影响,选取2014年6月至2016年11月间广元市第一人民医院消化内科诊治的86例胃溃疡患者为研究对象。采用流式细胞仪测定CD4^+T细胞和CD8^+T细胞亚群的变化,以CD4^+T细胞的中位数为分界值,将患者分别分为高CD4^+T细胞组和低CD4^+T细胞组,每组43例;以CD8^+T细胞的中位数为分界值,将患者分别分为高CD8^+T细胞组和低CD8^+T细胞组,每组43例。比较埃索美拉唑四联方案治疗不同水平CD4^+T细胞和CD8^+T细胞组患者的临床疗效以及CD4^+T细胞、CD8^+T细胞水平与临床指标的相关性。结果显示,CD4^+T细胞水平与患者临床症状指标之间均成显著负相关(P<0.05),而CD8^+T细胞水平与患者临床症状指标之间均成显著正相关(P<0.05);低CD4^+T细胞组患者的总体有效率为79.07%,显著低于高CD4^+T细胞组的95.35%(χ2=5.108,P=0.024);而低CD8^+T细胞组患者治疗总体有效率为97.67%,明显高于高CD8^+T细胞组的81.39%,差异具有统计学意义(χ2=6.081,P=0.014);此外,高CD4^+T细胞组患者疼痛、烧灼感、恶心呕吐、嗳气和腹胀的评分值也明显低于低CD4^+T细胞组(P<0.05);但CD8^+T细胞组疼痛、烧灼感、恶心呕吐、嗳气和腹胀的评分值均明显高于低CD8^+T细胞组,差异均有统计学意义(P<0.05)。上述结果表明,CD4^+T细胞和CD8^+T细胞水平可影响埃索美拉唑四联方案治疗胃溃疡患者的临床疗效。

To investigate the effects of peripheral blood T cell subsets on the clinical efficacy of esomeprazole quadruple program in the treatment of gastric ulcer, 86 cases with gastric ulcer were recruited from June 2014 to November 2016 in the First People＇s Hospital of Guangyuan. The changes of T lymphocyte subsets CD4＋ and CD8＋ were measured by flow cytometry. The patients were divided into high/low CD4＋ and CD8＋ groups according to the median values of CD4＋ and CD8＋ , respectively. The clinical efficacy of esomeprazole quadruple program on gastric ulcer were compared among different CD4＋ and CD8＋ levels groups. Our results showed that the overall effective rate of low CD4＋ group was 79.07%, which was significantly lower than that in the highCD4＋ group （95.35%）（X2=5.108, P=0.024）. The overall effective rate of low CD8＋ group was 97.67%, which was significantly higher than that of high CD8＋ group （81.39%） （X2=6.081, P=0.014）. In addition, pain, burning sensation, nausea and vomiting, belching and abdominal distension scores of the high CD4＋ group were significantly lower than those in the low CD4＋ group （P 〈 0.05）. In contrary, the corresponding scores in the high CD8＋ group were significantly lower than those of the low CD8＋ group （P 〈 0.05）. Our findings indicate that esomeprazole quadruple program treatment may be more effective in patients with higher CD4＋ level or lower level of CD8＋.