慢性萎缩性胃炎伴Hp感染患者血清GH、PGⅠ/PGⅡ、TGF-βRⅡ、IL-6和TNF-α水平的变化及临床意义

Changes and clinical significance of serum GH,PGⅠ/PGⅡ,TGF-βRⅡ,IL-6,and TNF-αlevels in patients with chronic atrophic gastritis complicated with Hp infection

目的探讨慢性萎缩性胃炎伴幽门螺杆菌(Hp)感染患者血清生长激素(GH)、胃蛋白酶原Ⅰ(PGⅠ)/PGⅡ、转化生长因子β受体Ⅱ(TGF-βRⅡ)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平的变化及其临床意义。方法选择2018年2月至2020年2月安康市中心医院收治的72例慢性萎缩性胃炎患者作为观察组,并选择同期于我院接受体检的70例健康者作为对照组。采集纳入研究后次日空腹静脉血,检测并比较观察组和对照组、观察组Hp感染阳性和阴性患者和对照组血清GH、PGⅠ/PGⅡ、TGF-βRⅡ、IL-6、TNF-α的表达水平,并采用Pearson相关性分析法分析血清GH、PGⅠ/PGⅡ与TGF-βRⅡ、IL-6、TNF-α的相关性。结果观察组患者的血清GH、PGⅠ/PGⅡ、TGF-βRⅡ分别为(18.32±3.71)ng/mL、5.71±0.86、(24.92±3.40)ng/mL,明显低于对照组的(34.09±4.20)ng/mL、9.16±1.79、(49.11±4.92)ng/mL,血清IL-6、TNF-α分别为(18.20±2.51)pg/mL、(8.42±1.81)pg/mL,明显高于对照组的(7.02±2.17)pg/mL、(2.10±0.53)pg/mL,差异均有统计学意义(P<0.05);观察组患者的Hp感染率为58.33%,Hp感染阳性组患者的血清GH、PGⅠ/PGⅡ、TGF-βRⅡ分别为(14.27±3.60)ng/mL、4.83±1.03、(19.48±2.75)ng/mL,明显低于Hp感染阴性组的(23.18±3.21)ng/mL、(6.70±1.26)、(30.08±3.40)ng/mL,血清IL-6、TNF-α分别为(25.62±3.74)pg/mL、(15.72±3.08)pg/mL,明显高于Hp感染阴性组的(10.74±2.26)pg/mL、(5.41±1.33)pg/mL,且Hp感染阳性和阴性患者血清GH、PGⅠ、PGⅠ/PGⅡ、TGF-βRⅡ明显低于对照组,血清IL-6、TNF-α水平明显高于对照组,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,血清GH、PGⅠ/PGⅡ与TGF-βRⅡ均呈正相关(r=0.348、0.410,P<0.05),与IL-6、TNF-α均呈负相关(r=-0.391、-0.377、-0.453、-0.389,P<0.05)。结论慢性萎缩性胃炎伴Hp感染患者的血清GH、PGⅠ/PGⅡ、TGF-βRⅡ水平表达降低,IL-6、TNF-α水平升高,在早期筛查、病情评估中具有重要的临床意义。

Objective To explore the changes and clinical significance of serum levels of growth hormone(GH),pepsinogen(PG)Ⅰ/PGⅡ,transforming growth factor-βreceptorⅡ(TGF-βRⅡ),interleukin-6(IL-6),and tumor ne-crosis factor-α(TNF-α)in patients with chronic atrophic gastritis complicated with Helicobacter pylori(Hp)infection.Methods From February 2018 to February 2020,72 patients with chronic atrophic gastritis admitted to Ankang Central Hospital were selected as the observation group,and 70 healthy people who received physical examination in our hospital during the same period were selected as the control group.The fasting venous blood of the patients on the next day after being included in the study was collected to detect and compare the levels of serum GH,PGⅠ/PGⅡ,TGF-βRⅡ,IL-6,and TNF-αbetween the observation group and the control group,between Hp infection positive and negative patients in the observation group and the control group.Pearson correlation analysis was used to analyze the correlation between se-rum GH,PGⅠ/PGⅡand TGF-βRⅡ,IL-6,TNF-α.Results The level of serum GH,PGⅠ/PGⅡ,and TGF-βRⅡwere significantly lower in the observation group than in the control group(P<0.05):GH,(18.32±3.71)ng/mL vs(34.09±4.20)ng/mL;PGⅠ/PGⅡ,(5.71±0.86)vs(9.16±1.79);TGF-βRⅡ,(24.92±3.40)ng/mL vs(49.11±4.92)ng/mL.The lev-el of serum IL-6 and TNF-αwere significantly higher in the observation group than in the control group(P<0.05):IL-6,(18.20±2.51)pg/mL vs(7.02±2.17)pg/mL;TNF-α,(8.42±1.81)pg/mL vs(2.10±0.53)pg/mL.The Hp infection rate was 58.33%in the observation group,and the level of serum GH,PGⅠ/PGⅡ,and TGF-βRⅡwere significantly lower in the Hp infection positive group than in the Hp infection negative group(P<0.05):GH,(14.27±3.60)ng/mL vs(23.18±3.21)ng/mL;PGⅠ/PGⅡ,(4.83±1.03)vs(6.70±1.26);TGF-βRⅡ,(19.48±2.75)ng/mL vs(30.08±3.40)ng/mL.The se-rum level of IL-6 and TNF-αwere(25.62±3.74)pg/mL and(15.72±3.08)pg/mL,respectively,which were significantly higher than corresponding(10.74±2.26)pg/mL and(5.41±1.33)pg/mL in the Hp infection negative group(P<0.05).The level of serum GH,PGⅠ,PGⅠ/PGⅡ,and TGF-βRⅡin patients with positive and negative HP infection were all significantly lower than those of the control group,and the serum IL-6 and TNF-αlevels were significantly higher than those of the control group,with statistically significant differences(P<0.05).Pearson correlation analysis showed that serum GH,PGⅠ/PGⅡand TGF-βRⅡwere positively correlated(r=0.348,0.410,P<0.05),and were negatively correlated with IL-6 and TNF-α(r=-0.391,-0.377,-0.453,-0.389,P<0.05).Conclusion The expression of serum GH,PGⅠ/PGⅡ,and TGF-βRⅡdecreased in patients with chronic atrophic gastritis complicated with HP infection,and the levels of IL-6 and TNF-αincreased,which has important clinical significance in early screening and disease assessment.