胃镜下幽门螺杆菌感染慢性萎缩性胃炎儿童的胃黏膜病变严重程度与炎症因子的关系

Correlation between the gastric mucosal lesion severity and inflammatory factors in children with Helicobacter pylori-infected chronic atrophic gastritis under capsule gastroscopy

[目的]探讨胶囊胃镜下幽门螺杆菌(Hp)感染慢性萎缩性胃炎儿童的胃黏膜病变严重程度与炎症因子的关系。[方法]选取92例慢性萎缩性胃炎患儿。经^(13)C尿素呼气试验诊断将Hp感染阳性列为观察组(48例)、Hp感染阴性列为对照组(44例),分别采用胃镜观察胃腺体萎缩程度及采用酶联免疫吸附法测定血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、超敏C反应蛋白(hs-CRP)表达水平,并分析胃腺体萎缩程度及炎症因子表达水平的相关性。[结果]观察组胃腺体萎缩程度显著高于对照组,差异具有统计学意义(P<0.001);观察组血清IL-6、TNF-α、IFN-γ、hs-CRP等炎症因子水平均高于对照组,差异具有统计学意义(P<0.001);各组血清hs-CRP比较差异无统计学意义(P>0.05);重度胃腺体萎缩程度组血清中IL-6、TNF-α、IFN-γ水平均高于中度组、轻度组,且中度组高于轻度组,差异均有统计学意义(P<0.05)。胃腺体萎缩程度与血清IL-6、TNF-α、IFN-γ水平呈正相关(P<0.001),与hs-CRP表达水平不相关(P=0.842)。[结论]慢性萎缩性胃炎患儿IL-6、TNF-α、IFN-γ、hs-CRP表达水平与Hp感染有关,且与胃黏膜病变程度呈正相关,这些炎症因子表达水平的变化可作为患儿进展病程中的提示指标。

[Objective]To explore the correlation between the gastric mucosal lesion severity and inflammatory factors in children with Helicobacter pylori(Hp)infected chronic atrophic gastritis under capsule gastroscopy.[Methods]Ninety-two children with chronic atrophic gastritis admitted to our hospital from January 2020 to January 2022 were selected.Children were assigned into observation group(n=48,positive for Hp infection)and control group(n=44,negative for Hp infection)according to the status of Hp infection in 13 C-urea breath test(^(13)C-UBT).The degree of gastric mucosal atrophy was microscopically observed using immunohistochemical method,and the expression levels of serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)and high sensitive C-reactive protein(hs-CRP)were measured by enzyme-linked immunosorbent assay,respectively.Then the correlation between the degree of gastric mucosal atrophy and the expression level of inflammatory factors was discussed.[Results]The degree of gastric mucosal atrophy in observation group was significantly greater than that in control group(P<0.001).Serum hs-CRP level yielded no statistical difference among patients with different atrophy degrees(P>0.05),while serum levels of IL-6,TNF-α,and IFN-γamong patients with different atrophy degrees were the highest in severe group,followed by moderate group,and were the lowest in mild group,with statistical difference(P<0.05).The degree of gastric atrophy was positively correlated with the serum levels of IL-6,TNF-αand IFN-γ(P<0.001),but was not correlated with the expression level of hs-CRP(P=0.842).[Conclusion]The expression levels of IL-6,TNF-α,IFN-γand hs-CRP in children with chronic atrophic gastritis are associated with Hp infection,and positively correlated with the extent of gastric mucosal lesions,indicating that the above inflammatory factors can be used as indicators of the progressive course of the disease in children.