维生素B_(12)联合四联疗法治疗幽门螺杆菌阳性慢性萎缩性胃炎患者的效果

Effects of vitamin B_(12) combined with quadruple therapy on patients with Helicobacter pylori positive chronic atrophic gastritis

目的:观察维生素B_(12)联合四联疗法治疗幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)患者的效果。方法:选取2019年1月至2022年2月该院收治的100例Hp阳性CAG患者进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各50例。对照组采用四联疗法,观察组在对照组基础上联合维生素B_(12)治疗,两组均持续治疗3周。比较两组临床疗效、治疗前后血清学指标[胃泌素(GAS)、C反应蛋白(CRP)、可溶性白细胞介素-2受体(SIL-2R)]水平、T细胞亚群指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平、治疗后不同时间点(治疗后1、2、3周)Hp转阴率和不良反应发生率。结果:治疗3周后,观察组治疗总有效率为96.00%(48/50),高于对照组的82.00%(41/50),差异有统计学意义(P<0.05);观察组GAS、SIL-2R、CRP水平均低于对照组,差异有统计学意义(P<0.05);观察组CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05);观察组治疗后1、2、3周的Hp转阴率均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:维生素B_(12)联合四联疗法治疗Hp阳性CAG患者可提高治疗总有效率和Hp转阴率,改善T细胞亚群指标水平,降低血清学指标水平,效果优于单纯四联疗法治疗。

Objective:To observe effects of vitamin B_(12) combined with quadruple therapy on patients with Helicobacter pylori(Hp)positive chronic atrophic gastritis(CAG).Methods:A prospective study was conducted on 100 Hp-positive CAG patients admitted to the hospital from January 2019 to February 2022.They were divided into observation group and control group according to the random number table method,50 cases in each.The control group was treated with quadruple therapy,while the observation group was treated with vitamin B_(12)on the basis of that of the control group.Both groups were treated for 3 weeks.The clinical efficacy,the serological index levels[gastrin(GAS),C-reactive protein(CRP),soluble interleukin-2 receptor(SIL-2R)],the T cell subsets index levels(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))levels before and after the treatment,the Hp negative conversion rate at different time points after the treatment(1,2,3 weeks after the treatment),and incidence of adverse reactions were compared between the two groups.Results:After 3 weeks of treatment,the total effective rate of the observation group was 96.00%(48/50),which was higher than 82.00%(41/50)of the control group,and the difference was statistically significant(P<0.05).The levels of GAS,SIL-2R and CRP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,the level of CD8^(+)was lower than that in the control group,and the differences were statistically significant(P<0.05).The Hp negative conversion rates in the observation group were higher than that in the control group at 1,2 and 3 weeks after the treatment,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Vitamin B_(12)combined with quadruple therapy in the treatment of the Hp positive CAG patients can improve the total effective rate of treatment and the Hp negative conversion rate,improve the levels of T cell subsets,and reduce the levels of serological indicators.Moreover,it is superior to single quadruple therapy.