慢性萎缩性胃炎患者根除幽门螺杆菌治疗前后红细胞免疫功能的变化

The changes of erythrocyte immune function in patients with chronic atrophic gastritis before and after Helicobacter pylori eradication

[目的]比较幽门螺杆菌(Hp)阳性的慢性萎缩性胃炎患者在四联疗法根除Hp前后红细胞免疫功能的变化,旨在探讨红细胞免疫功能在根除Hp后的变化,从而为根除Hp预防早期胃癌提供新的理论依据。[方法]90例Hp阳性的慢性萎缩性胃炎患者(Hp根除前组)通过流式细胞术检测红细胞免疫功能(红细胞补体受体1和CD44),然后给予四联疗法(艾司奥美拉唑、枸橼酸铋钾、阿莫西林、左氧氟沙星),疗程14 d。全部患者停药4周后行^(14)C呼气试验复测Hp,Hp阴性患者再次检测红细胞免疫功能。比较Hp根除前后红细胞补体受体1(CR1)和CD44的变化情况。85例Hp阴性的健康体检者作为正常对照组,检测其红细胞免疫功能。[结果]Hp根除前组90例患者在根除Hp治疗后有82例复测Hp阴性(Hp根除后组);Hp根除后组和正常对照组较Hp阳性根除前组红细胞CR1和CD44有显著升高(均P<0.05),而Hp根除后组与正常对照组比较均差异无统计学意义(均P>0.05)。[结论]慢性萎缩性胃炎患者在根除Hp后红细胞免疫功能有显著改善,可通过红细胞免疫发挥免疫防御作用,从而预防早期胃癌的发生。

[Objective]This study was to compare the changes of erythrocyte immune function in patients with chronic atrophic gastritis before and after Helicobacter pylori(Hp)eradication by quadruple therapy.The purpose of this study was to explore the changes of erythrocyte immune function after Hp eradication,so as to provide a new theoretical basis for Hp eradication to prevent early gastric cancer.[Methods]The erythrocyte immune function(RBC complement receptor 1 and CD44)were examined by flow cytometry in ninety cases of Hp infected patients with chronic atrophic gastritis,and then the patients were treated with quadruple therapy(esomeprazole,bismuth potassium citrate,amoxicillin and levofloxacin)for 14 days.The^(14)C breath test was tested in all the patients 4 weeks after the cease of the treatment.The erythrocyte immune function of the Hp-patients was tested again.The changes of RBC complement receptor 1(CR1)and CD44 were compared before and after Hp eradication.Eighty-five cases of Hp-healthy people were used as the normal control group to test their erythrocyte immune function.[Results]In the 90 cases of Hp+patients with chronic atrophic gastritis,Hp was successfully eradicated in 82 cases.The quantities of RBC CR1 and CD44 in 82 Hp-patients after Hp eradication group and 85 normal control group were significantly higher than those in 90 Hp+patients before Hp eradication group(P<0.05),but there were no significant difference between 82 Hperadicatedpatients and 85 Hpnormal control cases(P>0.05).[Conclusion]After eradicating Hp,the erythrocyte immune function in patients with chronic atrophic gastritis has been improved significantly.Erythrocyte immunity can play an immune defense role to prevent the occurrence of early gastric cancer.